But Johnny got out a pair of hotpads|
and got out Chet's breakfast from
the oven where it still
began cutting it up for Chet industriously
with fork and knife. "Need help eating this?"
he asked, not unkindly.
"I got it. Just cut the steak into smaller pieces."
fumbling with his fork in his abundantly
wrapped hands. He stubbornly stabbed an
egg onto the fork
using his chin and both
Marco noticed his difficulty and said,
not driving home that way.."
"Says me.." Cap said with authority.
has already offered to drive you
home. Now do you have someone around
to help you about the house
healed up in a few days?"
"I can call my sister. She owes me one.
I took care
of her when she busted both legs
skiing last winter."
"Ouch.." Johnny said, swiping some toast
over his rapidly emptying plate. "Did she
have fun doing it?"
"About as much fun as I had busting
knuckles, and thanks for asking." Kelly
"Hey, how was I to know? Most people
for enjoyment's sake." Gage complained.
"Yeah? Well, my sister skis like I work out when
both get upset about stuff."
"And you both get hurt doing it." Roy said
all the time, DeSoto. Just that one time
for her, and now this time, for me.." he said,
up his splinted palms.
"Just make sure your brand of therapy follows
less aggressive routes
next time Kelly, or there
will be h*ll to pay." Cap warned. "I had to talk
a blue streak to keep
the Chief from disciplining
you about your little stunt this morning."
Kelly was properly abashed.
"Thank you." he
said very fast.
"Call the Chief when breakfast is over. He
wants to talk
"But, Cap, I thought you said you got me out
of hot water...."
"This is about
something else, Kelly." Cap toned
"Then get back in here and tell us what
was all about. Sounds important."
Soon, Chet had finished manhandling his
into his stomach and made the call to McConike
from Cap's office. Minutes later, he shuffled
into the kitchen, numbly sitting back down into
"Kelly, you ok?" Roy asked.
Chet looked up and his face was devoid
of humor or pleasure. "Chief says I should start
a look at the red book from Cap's
office pronto like. "
"Oh really? Wh-What's the red book?"
Gage asked, pretending pretense.
Chet didn't say anything.
Cap got up and disappeared into
He returned with an unfamiliar fat, red book in his
hands. "This book. Chet, The chief
you to know the basics by the time you're back
on the duty rosters.. I'm sorry,
buddy. I just
didn't think the chief would really consider
this course of action so soon."
Chet read the cover and his face fell with remorse.
"Oh, Cap.." he sighed. "I- I can't do this..
isn't right." Kelly's closed his eyes. "This is the
engineer's manual. Seems I've been chosen
be next in line for that position on the engine
if Stoker doesn't make it back to the actives
From : "patti keiper" <firstname.lastname@example.org>
The Long Tiny Steps..
Date : Thu, 06 Feb 2003 06:47:31 +0000
Tom Stafford - Firefighter Captain /MD on
Chemical Firetruck Training Procedures
Dr. Jeff Seltun for Pulmonary Scalding Lab Test
Orders and General Ophthalmology Medicine.
Dr. Brackett was paged to Mike Stoker's
room around noon. Joe Early was on hand
call light came on from the observation
nurse. Stoker was semi awake and beginning
to fight the
respirator. Kel leaned over the bed.
"Beth, get Dixie in here." Kel ordered.
The critical care
nurse used the wall phone near
Mike's head to summon her.
Dr. Brackett leaned close. "Mike.
It's ok. You're
in the hospital and you've been intubated to
counteract the spasming effects of
you have in your throat. Try to relax. We'll
evaluate you to see if we can let you try
breathe on your own off the respirator."
Stoker stopped struggling, but then his
went to his face. Dixie arrived just in
time to help Beth gently restrain him from
burned areas on his face around
the eye dressings. "He's relaxed about having
his eyes covered
at least.." she said.
Beth piped up, "That's because his station crew
mates were up here telling
him what to expect
when he woke up. Mike, besides Dixie and me,
Dr. Brackett and Dr. Early are
The two nurses quietly spoke to Mike while
Kel and Joe consulted after a quick exam
his chest and breath sounds. They stood
at the foot of the bed so Mike wouldn't hear
"What do you think, Kel? Too soon to go off
the bird?" Joe asked.
Dr. Brackett said, rubbing
his chin. "The danger of tracheal adhesion is
has passed. The initial
wheezing we heard when
he was admitted has gone away. I think we
can go ahead and make him more
If we run into any problems, we can always bag
him until we can re-sedate him for
"I agree. Let's go ahead then."
"Dix, watch his BP." Joe said
and together, the
two doctors instructed Mike how to manage
himself while the respirator was turned
and the EOA removed. Beth was right there
with a hissing suction tube to carry away liquids
the slender airway was taken out.
Stoker wanted to cough and he winced from
of burns deep inside. He let himself
blank out to end the pain. He felt the nurses
pull him onto
his side to drain out his throat
for him and his alarm grew when his diaphragm
refused to pull
any air into his lungs when
he felt the suctioning wand leave his mouth.
"BP's dropping. 88/46.."
Kel reached for the diazepam syringe pack on
the crash cart and tossed it onto
so it would be nearby.
"Mike." Joe called out. "Give it a few seconds.
feeling will ease off. Then see if
you can try to inhale on your own. Don't worry.
If you can't,
we'll support you with 02 on an ambu
bag until you're ready to do it on your own."
one ready and flowing on standby.
Kel stood listening with a stethoscope as Mike's
rose higher as the firefighter worked through
his fright and the natural cramping of his wounded
throat in response to the airway's removal. Finally,
after half a minute, Stoker's muscles relaxed
he took in a ragged involuntary breath, tentative,
slipped a simple clear,
non rebreather mask over his face on full flow
sending Beth with the ambu
bag valve mask
away with a nod. "There."she said. "You did it,
Mike. Now relax." Everyone in
the room sighed
in relief. Mike's tracheal blistering hadn't harmed
his ability to breathe at
The EKG settled fitfully into a normal but fast
sinus rhythm that slowed increment by
with each successful breath Mike drew in.
After a minute, Dix announced.
pressure's back up. Settling in at
120/62." she told the doctors.
Dr. Brackett put the sedative
onto the crash cart and hung his head in
Beth placed her hands on either side |
of Stoker's face so he knew she was near.
"Having any pain
now anywhere else besides
your sore throat and face ?"
Stoker shook his head and gurgled when
he tried to talk.
"Don't." Dix told him. "Not yet.
Swallow. Again. Now wait a minute or two
before you even think about trying to talk."
"The rocky part's over Mike. I promise you
more surprises like that." Kel frowned.
Dr. Brackett listened to Mike's chest and upper
again with a stethoscope while Joe
began to unwrap Mike's eyes bit by bit for a
exam. He kept them patched
until he nodded at Beth to wave the room lights
down to complete darkness
except for the
pinpoint spot from his ophthalmoscope.
The saline soaked patches came away.
Stoker's raspy voice whispered to them.
"I can't see.."
Kel's face softened. "That's because
the room lights turned off to make it
easier on you. You also have some
the tissue around your eyes and
both of them have swelled shut. Just relax,
Mike. We'll know soon
enough what's going
on after Joe takes a look at you. Does your
chest hurt at all?"
he sighed, still whispering.
"Good. Your bronchoscopy didn't show any
major damage to your
pulmonary tissues. Only
some localized scalding above your larynx.
The collapsed airway you suffered
the fire reopened again nicely once your coworkers
got you back outside away from all the
"I stopped breathing?" Mike asked.
Joe and Kel hesitated. Then Dr. Brackett
into a disclosure. "For a while. Enough
to lose a viable heart rate. But there was no
in reconverting you. You were down
for only a minute or so and Johnny and Roy got
you back effectively
enough to matter until you
got to the hospital and we could stabilize your
vital signs. You ran
no hypoxia risks at all."
"I almost died?" Stoker asked again.
"Almost only counts in horseshoes
hand grenades, Mike Stoker. And you know
it." Dixie said. "Now lie still and let the doctors
finish examining your eyes." she said no
Mike stayed hushed.
Joe said. "Mike
this may hurt a bit when I
shine the scope's light into the back of your
eyes. I need to see what's
the deeper structures there."
Stoker gasped when the light shone down.
was a mass of shadows and shocking
white flares which smeared together in sparking
His head began to fill
with pulsing stabs of agony.
Mike's EKG sped up suddenly.
immediately quelled the light. "What
did you see?"
Stoker told him.
Kel and Joe glanced
at each other.
Dr. Brackett said. "There may be some
fundus involvement here. Perhaps even
the optic disc itself. But then again,
those visual anomalies could just be the
of superficial corneal burns.
Try it again Joe."
Once more, Joe used his scope to peer around
Stoker's red swollen eye lids into the eyes below.
This time, Mike's discomfort doubled. His
shot up and gripped Joe's wrist.
"Ahh.. don't...!" His sharp movement made
Dr. Early drop his instrument
onto the pillow.
"All right. I'll stop." Joe said quietly.
Kel and he and Dix and Beth
worried looks. Then Joe gripped Mike's hands
in firm comfort and he returned them
under the blankets. "Ok, that's enough from us for
now. We'll repatch your eyes with more
salve and try again in a few days."
Mike didn't say anything and his heart rate
remained fast and panicked.
Kel said. "Don't let this dishearten you at all, Mike.
it takes days or even weeks for normal
retinal responses to return to the eyes following
like this. But from what we did
see here, your eyes are intact. Both your scleras
swollen and red and your pupils
are adjusting somewhat irregularly due to the
burns there, but
globally, at this stage, things are
looking about as well as we all expected."
Mike let the
nurses rebind his head tightly, to keep
out any more light before he spoke again.
Just how well is 'As well as
They didn't say anything.
Mike filled the
silence. "You know, six years ago,
Kip Jenkins from Station 16's took a spark on
the eye just standing
roof watch. And it cost
him his job when it later healed over, leaving him
with tunnel vision on
that side." He swallowed.
"Is that going to happen to me?"
Kel kept his hand on Mike's arm.
"It's too soon
to tell, Mr. Stoker. Only time will show us any
final outcome here."
I know..." Stoker said, folding his hands
over his chest, trying to pull shreds of dignity
himself as he would a turnout coat against
the blazing heat of a fire. "I just don't like being
in the dark..."
Dixie looked down.
"Sorry.." Mike apologized for the black feeling joke.
Kel said to him. "Mike, let's see how the rest|
of you is doing in the meantime. Joe, let's order
another set of arterial blood gases to see how
well it's working out for Mike being off support
like this. Also, I want to get a second chest X-ray to
compare it to the one we took last night. Dix,
the lab to get electrolytes, a urinalysis, a BUN,
a creatinine series and I want respiratory
to get in here to start some pulmonary function
tests on Mike's lung performance."
"I'll get right on it.." Dix said, moving to the phone.
"I'd just wish I could find out answers
faster. Not knowing anything's killing me.."
Stoker sighed, gasping through the oxygen
Brackett chuckled in his throat.
"Trying being a doctor and compounding
problem in the form of fifteen
new patients a day. Now you know why doctors
like me grumble so
much.." he grinned wryly for the
nurses benefit. "One step at a time, Mike. It always
one step at a time.. For you, that means
that all you have to be is a patient patient and
rest will follow naturally. In your future, there
may be the slight chance of corneal transplantation
surgery. But your positive contrast vision tells me
that even that, might not be necessary in
Mike stayed numbly quiet as he attempted to
settle his labored breathing
around the burns
jabbing in his throat.
Kel sighed. "Just leave all the worrying to us. It's
we get paid for. See if you can get some rest, all right?"
"I'll try, doctor."
It was four days later on the exercise grounds
at the L.A. County firefighting training facility.
Station 51's usual fire inspection duty assignments
had been traded away to another sister station
so she could report with her crew solely for Chet Kelly's
benefit. He had passed the paperwork
the standby engineer's test and now was entering
the practical skills testing.
mockup of a two story apartment tower building
with a fuel truck spill at its base was the scenario
the chiefs had mapped out for Station 51's chemical
truck to handle. And on a signal, the whole facsimile
was set ablaze along the tarmack using hidden torches
embedded from spigots in the concrete.
Kelly.." encouraged Charlie Atkins, the replacement
engineer assigned to 51 until Mike Stoker's situation
fell one way or the other over the fence. "This is
an easy one. Think...grease. Now, what mix are
going to pick for your hoses?"
Chet Kelly watched Marco, Cap, Roy and John
at the ready, aimed at the fire's heart, and
they all looked back towards Chet at the chemical
on the engine for Chet's signal to let go
the charged hoses.
To one side, the Batallion Chief
was also drilling another
company as they broke in a new man on driving
a ladder truck around an
obstacle course. For the
moment, the gray haired supervisor's attention
wasn't on 51's exercise.
Chet Kelly bit his lip, checking and rechecking
the pumper readouts. "Repellent surfactant
....18% per hundred gallons ppm...with
every five hundred hydrant gallons from the
"Right. Right.. Gotta do that because fuel's
so volatile with our 21% air 02 ratio."
with a nod around the smoke drifting
towards them from the building.
"Now what else before you
release your mixed
reservoir to your crewmates?"
Click Engine Dials to go to Page Five :)