##Standing by, 51. Give me a new set of vitals and send me a strip as soon as|
you can. I want to
rule out cardiac involvement due to an electrolyte imbalance.
Specifically, I want to look for hyper
or hypokalemia. I've found that people who're
top gymnasts, sometimes get sensitive to those two conditions
touring hard professionally.##
Roy agreed. "He is a member of a circus troupe,
##Add 100 mgs Thiamine I.V. That'll lend you some momentum. Run that
through a saline
lock, just in case we have to adjust his blood glucose
"100 mgs Thiamine,
piggyback, with a saline lock." Roy confirmed.
Roy and Johnny soon had a flowing I.V. of sugar
solution entering Yuri's
veins. The young man did not awaken.
"He's gotta be real low, Roy."
Roy nodded to his partner. "Let's administer the glucagon. If he's gonna snap
out of it, it'll be then." DeSoto said, picking out an orange case that contained
a single vial of
powder and a sheathed syringe.
"What's that?" asked the bearded lady, finally returning with a
Sonya and Cap.
Gage smiled without looking up. "Glucagon is a hormone that the pancreas
makes. It raises blood sugar by turning sugar stored in the liver, glycogen, into
kind of sugar anybody needs for a little brain fuel. Hopefully,
this shot'll make him come to."
Both ladies nodded and Cap finally left them alone to watch silently.
Hank watched as Johnny
inserted the needle through the rubber seal disk
on the glucagon bottle. Then Gage injected all of
the liquid in the syringe
into the bottle. Then he left the syringe in place and gently shook the
until the white powder inside of it had completely dissolved. Then he
handed the whole
set up over to Roy.
DeSoto made sure the plunger was completely down to the zero mark
too, shook the vial and needle, leaving his finger on the plunger
to stop it from coming back up
due to its vacuum pressure. Then he gently
pulled the shot's grip out until all of the mixed hormone
solution was drawn
up into the syringe fully. Then he eyed it under a tent ceiling spotlight
be sure that all of the solid medication was truly dissolved.
Stoker carefully rolled Yuri over and pulled up one of his short's tights,|
exposing skin. Roy swabbed
the area down with an alcohol pad
and then gave the shot into upper, outer part of the man's buttock.
"Shall we draw a red top for the glucose level check the hospital's gonna
want?" Gage asked his
"Yeah, let's do that next. Mike, you can let him back down now. Easy.."
disposing of the spent glucagon needle into the sharps
bin of the drug box.
Roy was just about
to stick an empty blood drawing vacuum syringe
into the saline lock when Yuri came to. Violently.
One second he was
out and the next, he was talking and trying quickly to get onto his feet.
it! Watch it here! You've got a couple of I.V.s in!"
Gage said, as he, Cap and Roy all tried to hold
the man's wrists.
"Don't try to fight us or you'll hurt yourself.." Johnny yelled.
I'm Yuri Komenche', it's Monday, and I'm in the food tent. Let
me go! I'm fine.. Get off me!" said
the trapeze artist.
Hank, frowning, gave the order. "Boys, let him go. We can't restrain him
he's fully oriented to self, place and time. And that he is, by self
the two paramedics followed Cap's lead and let him loose.
"Good riddance. What IS all this?" said
Yuri angrily. "Why am I stuck
DeSoto took his helmet off into one of his hands
so he could wipe
perspiration off of his face with a napkin."You were passed out,
Yuri. And you're
even possibly coming out of a serious diabetic crisis."
Roy told him, still holding out a couple
of hands in the air, still
worried about the I.V. lock hub and line hanging off the man's skin,
where he stood.
"Me? Having the blood sugar disease?!" Yuri demanded. "I am not sick!"
with that, Yuri swiped a few fingers and pulled out the saline lock
and the other dextrose catheter
from both his arms. "I don't need these.
And I don't need you to tell me what might be wrong with
me. You are
not doctors! That much I know!" said the thickly accented man.
changed his expression from tense to neutral.
"Yes, that's true, a paramedic is no doctor. But we
do work through
one. And we've been doing just that from minute one, through
this phone line."
Johnny said, holding up the waiting biophone receiver.
"Makes no difference! Don't touch me."
"Yuri.. let's get out of here..." said Sonya, suddenly hurrying over to
side. Yuri blinked a few times, ridding himself of the sweat
running down into his eyes and he nodded
firmly in agreement.
They turned to go.
"Yuri, wait a minute. You're going to have to
release us from our
legal responsibility." Roy began.
"I just did!" shouted Yuri indignantly,
grabbing up a cup of juice to wet
his mouth. He drained the whole thing and accepted another that
else handed to him.
"On paper.." Cap told him firmly. "It's called an Against Medical
It'll only take a second..." said Hank, who towered over the diminuitive Yuri by
least a foot. "Then you can go about your business as usual."
"Fine. I will sign them." said Yuri.
Gage stepped forward. "Will you at least let us put on a couple of bandaids? You're|
over the place." he said, pointing to where Yuri's I.V. sites used
Yuri looked down
at his streaming arms. Finally he held them up with a shrug.
But Sonya shoved Johnny away. "No.
I will take care of him myself!" she said
fiercely. A part of what she said was addressed to the silent,
crowd around them.
Grudgingly, one by one, those other watchers nodded respectfully
them both in peace.
As Sonya twitched out of her blanket to give to Yuri, Johnny had
more parting comment to make as he accepted his green pen back and
the signed AMA papers. "You
do realize, the fact that he responded to
glucagon means that Yuri might be a new diabetic. Now that's
state to be in without a doctor overseeing developments. Especially
for someone coming
out of their first hypoglycemic crisis."
"He is not one. Do not tell us what we know not to be
true." said Sonya.
She ended the conversation by leading Yuri off to their box car on the train.
"Come on, Yuri.. We have only three hours before we go on. Come, you must
rest. And eat." she glared
at the two paramedics.
Once they were gone, the bearded lady leaned into Cap. "I thought he
real sick or something. Can they just leave like that?"
"They just did." Johnny replied flatly.
"And we have no power to stop
them as long as he's still awake. Because this paper says so."
"What a stupid document." she grumbled, drawing her furs more
closely around her sequined dress.
"Tell me about it." Roy stated wholeheartedly.
From: "patti keiper" <email@example.com>
Date: Sun Oct 29, 2006 9:17 pm
It was evening and the storm had long passed over
The gang from Station 51 were still enjoying themselves off duty.
wife, Joanne had even shown up with their children and the
delight was glowing in their eyes while
they laughed at the sights and
smells happily unfolding around them. Their laughter made a
noise that infected all the firemen, causing them all to
completely escape any thoughts of menial
Johnny offered Chris DeSoto another clump of cotton candy.
"So.. Did your dad and I
get stuck with a good enough work
assignment detail or what..." he said, nudging Roy's young son
"You sure did, Uncle Gage. This isn't working, this is playing."
"The rescue squad sure looks neat under all these lights."
"It does feel a little like the
fourth of July, doesn't it?" Chet chuckled,
munching on warmed up caramel corn.
on the star bangled bleacher seat as he stuffed more
pink sugar fluff into his mouth. "Hand the rest
of this to your sister,
Chris. She can't reach hers from over there."
"Ok." he said, tapping
the much younger girl until he had her attention
free from colorful distractions. "Eat up." he encouraged
falling way behind the rest of us. Here. I'll hold your lemonade." he offered.
Joanne and Roy were knotted around one another as they leaned |
up against a supporting tent pole
in a blissfully companionable hug.
Mrs. DeSoto leaned into him. "This is real nice. For once, your
doesn't smell like fire smoke."
Roy chuckled. "You should have been here earlier. Johnny
and I were
up to our necks in some of the stuff. We found ourselves right in the middle
"You were? Where?" Joanne grinned, peering at her husband suspiciously.
"I don't see
anything that's burned down."
"Oh. It wasn't a what. It was who. And he's not here right now."
looking at her with a smirk.
Joanne made a face, still seated in between the
two paramedics. "I'll ask
more about that, later. Glad the kids missed that kind of spectacle."
"Oh, they did it ok." Roy remarked, kissing Joanne on the cheek affectionately.
"You see, they didn't
toast just any guy. They smoked a clown."
"They what?!" Joanne laughed uproariously.
his sportspages. And it was hilarious." Johnny said to her,
finally over all misgivings about the
"I sure hope it was, for all the children in the audience's sake."
They buffered our pretend rescue with generous doses
of slapstick." DeSoto giggled.
we were slapping." added Gage.
Cap, seated and flanked by two miniscule DeSotos, opened his mouth
and out came a burst of rich toothy laughter. "Never thought I'd ever see
the day a fire horror was
joshingly fun poked. Wish I could've been there."
"You just might get your chance, Cap." Johnny
told him. "Mac the clown
told us we were such a hit doing that, that the ring master ordered the
scenario to be used every night for the rest of our circus's run."
"I just hope nobody gets hurt. You know I'd hate that." Joanne said.|
"It'll never happen." Roy
told his wife. "Not here. This is the circus."
Chet piped up. "Yeah, I passed a sign on the way
in that said it all, Joanne."
"What did it say?" she asked Kelly.
"The Samson Brothers'
Circus Extravaganza..Defying death every day."
Mike Stoker spoke up eagerly. "Shush.. SHhhhh."
he hissed. "It's starting."
he stage whispered. "I've been waiting for this act all night."
yeah.. This is gonna be Sonya Skye's act next, isn't it?" Marco asked.
"Yeahhh.." said Chet breathily.
"The... Birds of ...Paradox.. no." he corrected.
"..of..Paradise." he said, reading off his program
myopically in the glowing
"There are gonna be two of them?" Hank wondered. "We didn't
see a second girl
in the mess tent."
"We'll find out that answer soon enough." Lopez grinned.
"Two pretty girls for the
price of one? I can hardly wait. Sonya's costume was positively beautiful
saw her dash by a couple of minutes ago backstage. All diamonds and red velvet."
burst of ethereal music and the soft gushing of fog machines sighed as they
began to fill the circus
canopy above them full of mist. Two long bolts of red chiffon
floated down from invisible heights
in slow delicate tumbles. The hushed, warm
misty darkness was stabbed with dazzling sparkles as a
spotlight lanced down
and transfixed an athletically ballet posed Skye as she began her dance in
the air, suspended from the red cloth lengths.
The audience quieted, getting spellbound by the
sheer grace of her movements
and soft demonstrations of strength timed with the music. Everyone was
captived in a moment, caught in timelessness.
The music thunderclapped and harsh lighting stabbed
the ceiling, illuminating
a platform far above the crowds that was lowering itself above Skye's red
tethers. A trapeze artist in peach leaped for a suspended swing tied
above him and flipped to perch
himself onto it.
The two paramedics immediately got to their feet in shock. "That's Yuri! Oh|
my G*d. He's trying to
perform tonight?" Roy asked incredulously.
"Let's get down there. Maybe we can convince somebody
that this is sheer
craziness." Cap agreed. "He was in no shape to do anything tonight."
Watch the kids, we'll be right back." Roy told her.
The six firemen excused themselves and made
their way quickly off the
grandstand benches as they headed for the green room space
main performance ring.
They confronted the ring master as soon as they spotted him.
older man held up his hands. "I know what you're thinking. But it
wasn't me who authorized the go
ahead. Yuri's stubborn beyond belief
when it comes to performing. He must have used his emotional
over Sonya and then tricked the stage manager. I told him no."
"What do we do now? His
part of the act's already started." Gage
"There's not much we can do." said the ring
master. "There are no
radios or speakers up there."
"Put up the safety net." Cap told him.
"What?" sputtered the ringmaster.
"You heard me. I saw the crew rigging it to fire up from
under the sand
before the show." Stanley said.
"I can't do that. It's a matter of professional
courtesy to respect any
performer's wishes about how they want their acts run. Sonya and Yuri
flown above a net for years." the circus boss insisted. "Everyone
else will flay me alive if I betray
their confidence. If I deploy it now
while their act's still going on, I - "
he's a very sick man." Roy glared. "Yuri only looked like
he was recovering. That's how glucagon
works. It's only a temporary fix."
"Where's your triggering crew?" Cap roared. "His life is in
"I, uh, ..ok. Ok. I think Ike and Ben are over here. I'll - I'll go get them
now." said the ring master nervously.
"You'd better find them. You'd better hurry." Hank yelled
Then he turned to his men. "Are all circus folks this stupid?" he
asked Stoker angrily.
"They do seem like any grunt that's ever come out of the fire academy."
Roy and Johnny began to fret after they began hugging the curtains just|
shy of the lighted entrance
that led to the circus ring waiting for a miracle
A scream rippled out just then.
A single, high strangled yelp from a
frightened little girl seated just beyond the curtain and it
the hearts of all the firemen.
Far above, Yuri's had slipped off his trapeze
swing's bar after he missed
catching Sonya's supporting hand grip and his peach clad sparkling
was beginning to plummet like a limp rag doll to the ground.
Roy and Johnny burst into a frantic
run for the ring just as two circus
workers in black leaped for a red and white hand painted wooden
located alongside the main tent pole. It looked for all the world like
a railroad track control
arm lever. It was the net's trigger mechanism.
But they didn't reach it in time.
the deep sand sickeningly from his original height of forty
feet, and then he bounced up horribly
into the air, suddenly a broken
Only then did the net finally pop up in a cloud
of dust to form a protective
mesh cocooning around him as it elastically rebounded from the ground
on safety cables. Yuri was curled up into a ball inside of a second
smaller suspended net as the main
one finished deploying like a trampoline
"Get him down! Get him down now!" Gage
shouted to the circus men.
Sonya was the next to fall. She let go of her red cloth scarves and
on her back into the large net. Sobbing, she scrambled to the edge and
was helped off by
stagehands and lowered to the ground.
She ran for Yuri as the firemen grabbed him as his net was
The ringmaster made an immediate appearance in the center ring, |
gesturing animatedly. He was calling
for a clown troupe. "A var! A var!
Send them in!"
Loud carnival music began and on his order,
stunned clown performers
obeyed and began their act , ignoring the ring that was quickly darkened
next to them where the firemen and Sonya were kneeling over a gravely
squad was pulled up, lights and siren silent by hidden
assistants under the black cover of a blue
Roy looked up, and he minisculely shook his head at Cap while
he and Johnny
began an effort of futile resuscitation while the others
swiftly got a firm backboard and cervical
collar into place.
The endotracheal airway did not thread down, failing in the presence
damage from two collapsed lungs and multiple rib breaks. A doctor
ordered percutaneous needle cricothyrotomy
was begun carefully
in a pause between CPR sets.
Click the gymnast to hear a |
sung song. (dsl, broadband)
Click the trapeze artist to hear |
this song just instrumentally.
(dial up modems, webtv users)
Tears streaming down her face, Sonya took Yuri's blood|
stained fingers into her own and she began
to speak to him softly
with gentle words that desperately sought a warm tenderness.
pain and grief, Sonya's saddened heart quietly spilled
out only pure love as the others listened
while they frantically worked.
"Isn't it rich?|
Are we a pair?
Me here at last on the ground,
You in mid-air.
Send in the clowns.
"Isn't it bliss?
Don't you approve?
One who keeps tearing
One who can't move.
Where are the clowns?
Send in the clowns.
"Just when I'd
stopped opening doors,
Finally knowing the one that I wanted was yours,
Making my entrance again
with my usual flair,
Sure of my lines,
No one is there.
"Don't you love farce?
I thought that you'd want what I want.
Sorry, my dear.
But where are the clowns?
send in the clowns.
Don't bother, they're here.
"Isn't it rich?
Isn't it queer,
my timing this late
In my career?
But where are the clowns?
There ought to be clowns.
maybe next year."
From: "patti keiper" <firstname.lastname@example.org>
Tue Oct 31, 2006 9:25 pm
Subject: Freedom Of Choice..
Johnny Gage got on the biophone as
soon as the tenuous
emergency airway was in and the EKG turned on. He found that
he had to shout
over the circus music cranked over the tent's sound
system. Deep inside, he knew that distracting
the kids in the
audience was necessary, but another part of him was mad that
the show was still
going on as if the accident had never happened.
"Rampart, the needle crich was partially successful.
chest rise visually discernable with ventilations by bag valve
due to bilateral flail
segments, but he is not suffering any gross
cyanosis. More information, Rampart, Uh,...this is a
cardiac arrest due to a fall taken from a distance in excess of thirty
feet onto sandy
ground. He's been fully C-spine immobilized in the
position found. He struck dirt completely supine.
Note, he did not
land on his head."
Nearby, Marco was talking into the squad's HT. "L.A.,
We're requesting Life Flight to our twenty for a victim of a fall with
We've a male in his twenties currently in cardiac
##10-4, Squad 51. 'Copter Two
reports an arrival of three minutes.##
Captain Stanley nodded at Lopez. "Marco, go
outside and pace
them out a safe landing zone. Make it a hundred feet by a hundred.
Use five cherry
flares in a square with the fifth showing our location's
upwind direction. Get the area clear of any
debris that might possibly
become airborne. Then notify the pilot of any powerlines or nearby
towers and give him our wind speed along with a visibility report."
"Right, Cap." said Marco,
running for a side exit from the tent.
##51, are you detecting a carotid pulse with compressions?##
came the bio-comm's reply following Johnny's report.
"That's affirmative, Rampart." Johnny told
Dr. Brackett, gripping
the receiver in worried anticipation. He was very glad that his
had chosen this night to come to their circus gig.
Their aid was proving invaluable in more ways
than one. He could
feel their emotional professionalism buffering and calming him
the presence of Sonya's painful, knifing grief as
she started crying out loud, in shock, next to
##Ok, then it may be that his aortic and pericardial integrity is
still intact without
any significant ruptures. What's the scope
Roy took the phone from Johnny while Chet, Stoker and Cap |
continued Yuri's cardiopulmonary support.
It took two of them
to make sure the thin, needle threaded cricoid cartilage pierced
open and in place in Yuri's windpipe while CPR
continued. "Doc, we've still got coarse v-fib. He's
##Place him into antishock trousers first before defibrillating one
Ignore all limb and pelvic fractures when you use the
suit and don't worry about movement in his
back below the
waist. His circulatory priority is first. Inflate both the M.A.S.T.'s legs
abdominal compartments as far as they go. His chances of
making it back will be better if the worst
of his soft tissue and internal
bleeding is under control. Start two large bore I.V.s of Ringer's
of 1000 cc's each into both carotid arteries and hand pump them in
wide open. Turn them
down only if infiltration PE develops and you start
to get more solution than blood on suctioning.
If he doesn't convert
electrically, 51, provide continuous CPR and crico ventilations during
Get him in here by the fastest means possible. I'll have a full
surgical trauma team ready to meet
you. Deliver 1 mg 1/10,000
epinephrine IC and follow up with two amps sodium bicarb I.V.##
"10-4, two Ringer's large bore, M.A.S.T suit priority, 1 mg of 1/10,000
two amps bicarb, and defibrillate once.
Stand by." said DeSoto. Inwardly, he agreed with the minimal
order. ::That would only further exacerbate any damage he's already
taken. Our CPR's
already doing enough of that on its own.:: he thought
grimly. He tossed down the phone and accepted
the long needled syringe
Johnny handed to him. "Cap, can you get her clear?" DeSoto asked Stanley,
tossing a sympathetic head at Sonya as he uncapped the epi's six inch
"Yep.... Stoker, stop CPR. They have it ready." said Hank as he knelt by|
Miss Skye and gently took
her shoulders. "Sonya. Come on, hon. You have
to let go of him for a minute."
"I can't leave
him.." she sobbed. "He'll know that I let him go."
"Just for a minute. I don't want you to get
hurt when we try to cardioshock Yuri."
Cap told her gently. He finally had to pry her fingers away
from Yuri's hand.
Then he used his greater strength to lift her to her feet by her elbows.
Please.. Don't take me away...." she yelled. "It's not right!"
"It's for your own safety, Sonya.
Now let's look away from him. I want to
turn your back for a moment." Cap told her.
she screamed angrily.
"We have to give Yuri a heart injection. It's some medication that's very
like adrenalin. It might be something you won't want to see." Cap gently
immediately accepted Hank's shoulder into a hug, her mouth
gaping open as he turned her away. "Yuri's
"Now we don't know that. Only a doctor can say what his condition is for sure.
that's only after every other possible option and medical treatment has
been tried." Stanley explained.
::This whole code's being worked for her sake
now. So she'll have some comfort about Yuri's passing
later, knowing that we
at least tried everything to help him.:: Hank thought.
twisted in stifled grief and she fell silent in his arms as she
buried her cheek into his jacket with
her eyes closed. "I should have said
something to the ring master. And to you. Yuri does take insulin.
himself just before we went on..." she squeaked.
Roy looked up in horrified discovery at that. He knew that Yuri's glucagon |
probably had had some
side effects that caused a falsely high blood sugar
reading following its use. ::That was only temporary,
too. For a couple of hours
at the most. Yuri must have injected too much to counteract what he thought
was a normal food high and that must have crashed him into a rapid low
while he was still up on the
trapeze. Oh,..of all the-- this whole tragedy could
have been completely avoided. If only he had listened
to us...:: DeSoto
Gage stabbed the epinephrine home and pushed the plunger.
Roy." he said, pulling out the needle and checking its end to be sure all
of it was
still there and unbroken.
DeSoto nodded. Yuri's blood flecked body lifted under the paddles when
Roy delivered his wattage in a shock at the lowest setting any adult needed.
::120. That's the
least harmful.:: Intently, he eyed the monitor. "Nothing...
Guys, start up on him again." he told
the others. He picked up the phone.
"Rampart, no conversion. His rhythm's degraded into fine ventricular
##Bring him in, 51. I'm afraid that's all you can do for him out there. Maybe we'll
be able to do a little more for him once he's reached the hospital.## Kel encouraged.
Click the ball for a music change.
"10-4, doc. Our ETA's eight minutes. The chopper's here." Roy said.|
##See you soon, 51.## Brackett
said, signing off.
Soon, Yuri was packaged onto a gurney and wheeled out of the circus
Roy's family came running up to the squad once they saw that DeSoto had
begun packing the medical
gear Johnny didn't need on the chopper, away.
Chris couldn't contain himself and he ran into his
"Daddy, is that man dead?"
"Yeah, I'm afraid he is, Chris. I won't lie to you
about that. How's your sister
"She didn't understand. She thought it was part of the
act as another one of
your mock medicals." the boy sighed. "Mom wants us to go before she
out what really happened."
"That's a good idea. Are you doing ok? Seeing someone die unexpectedly's
gonna be hard for while. You shouldn't've seen that kind of thing at your age,
son. I'm sorry it had
to happen. I was..... hoping you'd be spared being
exposed to something like that, until you were....
old enough to join the fire
department." Roy told him, releasing their hug. Gently, he wiped Chris's
Chris's face screwed up in grief. "Why couldn't you save him, dad?" he sobbed.
Roy's expression grew quietly sad. "Sometimes, you can't save somebody who
doesn't want to be
saved. And that's all there is to it." he said, gripping Chris's
shoulders to show that he was completely
there for him. "I'll tell you about the
dark side of AMA forms someday. It's something I see a lot
of working as a
paramedic. But we won't talk about that today. I think we've seen enough
The younger DeSoto nodded bravely as he finally gave into his shocked
Roy just took his son deeply into both arms and let him
Twenty minutes later, Chet showed up to let Roy know that everything was|
back in order as far as
the squad and its equipment was concerned. He
noticed that Chris was a little numb and instantly,
he understood why. He spoke
up loudly, with a grin. "Hey, fellas." he said to them. "Did you hear
the fire at the circus?" he asked Chris, kneeling down next to him to offer
the boy an affectionate
head rub along with a steaming hot chocolate cup.
"No." said Chris softly.
"Yeah, man.. It was really "in tents." Kelly quipped.
Chris DeSoto's face split
into a tearful laugh and soon, he found that his
heart's pain had become.. just a little bit less..
than it was before.
Episode Thirty Eight
Emergency Theater Live
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