This is a text version of the original still airing imaged, music soundtracked story. Emergency Theater Live, Episode Forty Six 46. The Long Hours Season Six - Episode 46 Short summary- The gang rescues friend and victim at the pier. Waiting becomes especially hard when complications develop post rescue for all. ****WARNING**** The long summary to come is very story spoiling and will take away plot surprises if you read it now before reading the longer story below it. Decide now if you want to read this episode's detailed summary before doing so. . . . . . . . . . . . . . . . . Long Summary- Station 51 fills in for Station 110's fireboat on the ocean. Gage has a hankering to visit the beach. A light plane crashes off the Santa Monica Pier and both the gang and Baywatch lifeguards are called to assist. Dr. Morton is rescued from near drowning with a back injury and fractured arm. A surgeon's strike at Rampart threatens Morton's life when he is forced to be shipped to another hospital. Three generations are rescued from a burning house and treated for smoke inhalation. Kel is angered at a complication overlooked on his colleague and vows to stay at Morton's bedside through the crisis. Roy and Johnny assists at the intern's code blue seizure. The station responds to a bomb threat at the pier. A police officer is gravely wounded when it detonates. Dixie delivers good news about Morton so Chet, Roy and Johnny go visiting his bedside bearing a surprise homemade gift. . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Story Unfolds... Season Six, Episode Forty Six §§ The Long Hours §§ Debut Launch: June 1st, 2007. ------------------- http://groups.yahoo.com/group/emergencytheaterlive **ETL Writer's Preproduction List. *Cut and paste any link that is highlight broken into your browser address bar and the link will function. http://www.voyagerliveaction.com/emergency.html Emergency Theater Live Homepage. Click the TV set at the top of Emergency Theater Live's homepage to see the latest music soundtracked, imaged version of this episode after entering User ID 'efan' and Password 'frontrowseat' at the link above. This version of the current episode is scene delayed as compared to the most recent submissions shown in the text only file coming up below. You will need your Yahoo Email User ID and your Yahoo Email Password to access the file link below this sentence. http://groups.yahoo.com/group/EmergencyTheaterLive/files/OurTheaterTale/EmergencytheaterTaleinOneFile.txt **Location to the Complete Current Story ************************************************** From: Mark Panitz Subject: A Day At The Pier Date: Wed May 30, 2007 7:28 pm It was a beautiful summer day. Roy and Gage were just coming on duty. "What a beautiful day. Too bad we can’t go the beach." he said with a smirk, throwing his clean set of shower towels into the back of his locker with a snap of his wrist. Roy regarded his partner ruefully. "Be careful. Your wish might come true." Just then, the tones beeped. Engine 51 and Squad 51 were called to respond to a relocation move to station 110 by the marina as standby. “10-4, L.A." Captain Stanley replied. "KMA." he said, using that part of the county's affirmation. Johnny celebrated as he buttoned his shirt up the rest of the way as he followed Roy out to the vehicle bay. "Hey, I got my wish!" Gage replied. Roy just rolled his eyes as he opened up the squad's door. ---------------------------------------------------------------------------------------- Station 110 was out of service for the day, gone to the fire academy for training, so the gang made themselves quickly at home on the dock as their official for-a-shift fill in. They parked nearby and went out onto Station 110's pier to the main house located there. They soon spied the station's fire boat under the eaves. Seeing the boat brought back some memories for the gang as they arranged how they needed to be configured gear and apparatus wise for future calls. Johnny instinctively shuddered at the sharp sea breezes ruffling his hair. DeSoto, too, picked up his navy work jacket's collar. "Man, do you remember the guy who drove off Pacific Avenue into the channel?" Roy muttered, eyeing up the dark ocean shifting beneath their feet through the slates below as he rubbed his arms against the chill. "Boy do I." said Gage. "I was soaking wet!" he said, grabbing a couple of medical boxes from the squad's gear stow to set in the middle of the dock garage with a stokes near where the boat was housed in its water channel. He did so in order to make room so they could pack their water rescue equipment better inside the squad for quicker access. ----------------------------------------------------------------------------------------------- Meanwhile, at Santa Monica Airport, an instructor and student pilot where practicing take offs and landings. They had made three successful landings in what was known as the touch and go. On the last pass, as they took off again, they flew into a flock of seagulls coming off the waves, and one got noisily ingested into their front end single prop engine. In seconds, the feathery debris caused the engine to quit and the plane's occupants soon realized that they wouldn’t make it back over the airport. The instructor got on an emergency frequency on their radio. Fast. ##Mayday! Mayday! This is November 5622. We are going in!## he shouted at the control tower he knew was watching, as their plane crashed right off Santa Monica Pier, into the Pacific Ocean. ---------------------------------------------------------------------------------------------- Soon, down the beach, the tones began to sing. ##Engine 51, Squad 51. Respond with Santa Monica Fire on automatic aid to Santa Monica Pier. Baywatch lifeguards and the Coast Guard are also responding.## "Hey, that's on the sand beach." Roy yelled to the others. The gang responded to the busy tourist pier in minutes, in their trucks. They met up with Baywatch lifeguards, staring down into the water off to the north side, about half way down the recreational pier. Hank exited the Ward, putting on his turnout coat. "Do you know what we got?" he asked them. "Just now, a plane down. A student and instructor." said a young, dark haired lifeguard, putting on his life can float's elastic strap over his head and shoulder rapidly. He pointed to where a trail of bubbles was fizzing at the surface of the shallow sea. Underwater, they could see the outline of a crumpled Cessna haphazardly sprawled on its back in the murk whenever the wave crests receded into deep troughs. ------------------------------------------------------------------------------ Photos: None. ************************************************** From : Cassidy Meyers Sent : Sunday, June 10, 2007 3:58 PM Subject : Realm Of The Brave.. Stanley nodded, stepping up to the edge of the pier's railing, looking down. He could see a trail of air bubbles coming up from below. "Have you got people coming out?" he asked the guard. "Plenty. One wave cruiser. And a Sea King MK6 off that carrier you can see out there. They were nearby on maneuvers. Navy Air Rescue says they'll be here in two." "Why the navy?" asked Marco, tying off and throwing a rope down into the water far below as a reference point for themselves. "Isn't that highly unusual for them to handle a coastline rescue?" "The Coast Guard was typed up on another incident. And these guys were the closest alternative. Don't worry. They're good." replied the lieutenant. "We'll do a pier jump from the end and work our way back. The water's too shallow here. I've three more swimmers on the way." he said, pointing down the pier to where another cluster of swim suited life guards with ropes and torpedo cans were running towards them from the public beach towers nearest the pier. "We're going with you." said Gage, taking off his helmet and peeling out of his shoes. Beside him, Roy nodded, doing the same. "You're going to need all the help you can get if they're spinally injured. We have extra extrication gear." "And stokes." Roy added. "Okay. It's your call. But watch yourself. The current's are tricky around the pilings." advised the lifeguard. Roy chuckled, remembering the police helicopter they had attended to off the jetty located a quarter of a mile away from Santa Monica's pier last year. "We know." he chuckled, peeling out of his shoes. "Floats are valuable." he joked, pointing to the buoys the lifeguards were holding as they climbed up over the railing and stood on the edge to start timing the surf waves in preparation for their high jump. Stanley reassured the lifeguard. "We'll have our own back up boat here in a few minutes. You won't have to watch us at all." he said. Then he lifted his HT. "Engine 51 to HT 51. E.T.A. ?" he asked over the sound of seabirds and the waves. Chet Kelly's voice rang out over all their handy talkie's. ##Just rounding Point Loma. I'll be there in four with the gear. Scuba's already laid out.## "Good man." replied Cap. "Come even with the lifeguards' rescue boat. She's due here shortly. Squad 51's going in." ##10-4.## said Chet, shouting to be heard over the roar of the motor of Fireboat 110. ##I see your position clearly.## he said as he located the two red specks that were the squad and engine parked on the pier, just past the boardwalk cafes. Cap looked at Marco and Stoker. "Rappel down there using ropes, and act as stokes guides." he ordered. "Right, Cap." they replied as they ran back to the engine to get their belts. Looking up, Cap could just make out two white "V"s arrowing their way toward the accident site on the breakers. One of them was yellow. ::That's Malibu One, the Baywatch boat.:: he recognized. :: Well, for once, we've tied arrival times. So much the better for these victims. If they're still alive.:: he thought, punching down the antennae of his radio. As the three lifeguards, Roy and Johnny lined up on the railing, Gage leaned over to his partner. "Feel like changing your mind?" he said, holding his arms out to balance himself in the sharp breeze roaring around them. "What? And miss all this?" DeSoto grinned broadly. "Like you said, it's a beautiful day, junior. Just perfect for taking a swim." "All right." said Johnny, licking his lips as he counted the waves, looking for the deep cresting top of one. "Let's go." "After you..." Roy said with the sweep of his hand. "Funny man.." Johnny said, making a face, still hesitating. "I'm just.....being your spotter until you resurface again." Roy said, licking his own lips. "Uh huh..." Gage mumbled sarcastically. A triple impact on water sound decided Johnny before his reluctant nerves could. ::Those are the lifeguards, already jumping.:: he realized, crossing his arms across his chest protectively. Then he leaped out into open space as he put his bare stocking'd feet together. "Geronimo!" he yelled. And then he hit and went under the water. Roy splashed down a few seconds behind him once he saw Johnny's head was safely popped up once more in the rolling froth. Cap winced, suddenly embarrassed in front of the lifeguard lieutenant, when he saw the man's eyebrows go up. "Sorry. He gets a little enthusiastic at times." he shrugged. "Are you sure he's all paramedic once a victim's in his arms?" "Absolutely. He's one of the best." Cap grinned, leaning over to watch Marco and Stoker's progress climbing down the wooden pilings and buttresses beneath them. "I'll just take your word for it." the guard said, rubbing his eyes, doing the same. -------------------------------------------------------------------------------------------------- Photo: Lifeguards taking a leap off a pier, far away shot. Photo: Roy and Johnny in the water with a victim. Photo: The long stretch of the Santa Monica Pier, deck level. Photo: Palm trees showing the ocean and beach flockers. Photo: Cap and Stoker watching a scene below a rope tied engine. Photo: Marco, swiftly tying off ropes. Photo: A shallow water no diving warning sign on a pier boardwalk. ************************************************** From: MM Date: Thu Jun 21, 2007 12:15 pm Subject: A Friend In Need Swimming strongly, Johnny followed the three lifeguards out toward the wrecked plane. He could vaguely see the plane’s tail, not quite submerged in the water. As the lifeguards neared the downed plane, they could see two men in the water. One of them was holding onto a piece of wreckage and struggling to hold the second person’s head out of the water. Seeing help approaching, the man called out, “Help! He’s hurt...I can’t hold him much longer.” The first lifeguard of the group swam up to the men and carefully took hold of the injured man. As the others approached, he said, “I’ve got him now, sir. You just hold tight and we’ll have you taken care of momentarily.” He glanced back and was glad to see that Gage was only about twenty feet away. “I hope I didn’t hurt him.” the man panted. “I had to pull Mike out of the plane. I know he took in at least a little seawater. We had to submerge to get out. He said his back hurts and I could clearly see his right arm is broken. I didn’t have any way to stop the bleeding.” “Don’t worry. We’ll take good care of him.” the second lifeguard reassured him. “It looks like you need a little help yourself, sir.” he said, observing the bloody trail leaking from the man’s scalp. “The paramedics are right behind us. We’ll get you both taken care of.” Swimming up, Johnny began to assess the situation. He could hear Roy a few feet behind him. Seeing the first victim was conscious and oriented, he maneuvered himself around the two lifeguards supporting the second victim. He paused a split second as shock filled him - the victim was Dr. Mike Morton. Gage quickly spurred himself back into action and began examining his friend, speaking softly to him as he proceeded. “Doc? Can you tell me what happened?” “Johnny?” Mike managed to gasp out. Overhearing Johnny’s question, the pilot sputtered angrily, “We crashed, mister! That’s what happened. Isn’t it pretty obvious?” Roy had just arrived on the scene and turned to the pilot, gently explaining in his soft-spoken voice, “We know that, sir. My partner is trying to find out what Dr. Morton remembers.” Treading water, he glanced over at Johnny and Mike briefly while he spoke to the pilot; he wanted to help Mike but knew his first priority had to be taking care of *this* victim. Ignoring the burning in his own legs, he said, “You have quite a bump on your head there, sir. Did you lose consciousness at all?” ---------------------------------------------------------------- Meanwhile, Chet had picked up 51's remaining crew, the lifeguard lieutenant and the equipment. As they sped toward the scene of the plane wreck, Captain Stanley said to the lieutenant, “My paramedics are two of the county’s original paramedics. They’ve been trained since before the program was officially off the ground. Gage can act a bit like a twit at times but believe me, he and Roy are who I’d want tending me if I was hurt.” He paused momentarily, briefly reminiscing, then added, “For that matter they *did* treat me once when some power lines went down and I got zapped by the current.” ---------------------------------------------------------------- “Johnny?” Mike Morton mumbled again. He tried to focus but was having a difficult time doing so. He sputtered in surprise as a wave broke over the group, and then began coughing as he weakly fought the supine position the lifeguards held him in. “Hold still, Doc, we've got you.” Johnny said, his voice reassuring as he examined the intern as thoroughly as possible in the water. He grimly noted the compound fracture of Mike’s right humerus and the two-inch laceration on his head. “My back...pain...Johnny.” Mike stuttered, his voice laced with fear. He’d seen far too many cases where the victim had ended up paralyzed and he found himself terrified that he, too, might end up that way. “We’re going to have you out of here very quickly, Doc.” Johnny stated. “Can you tell me what you remember happening?” “Birds..those dratted gulls.” Mike moaned. “Then...we crashed. I think I was out a couple minutes...Harold was leaning over me...seat belt stuck...water coming in fast. My arm...couldn’t move it...my back...hurts. I think I went out again...next thing I knew we were in the water with Harold keeping me afloat.” Seeing the boat approaching in the distance, Johnny said, “We’ve got more help coming, Mike. Once they get here with our gear we’ll get you on your way to Rampart. Hang in there, okay?” Hearing the rattling in Morton’s chest, Johnny felt concerned about the amount of water his friend might have taken in. He briefly made eye contact with Roy, silently letting his partner know their friend appeared to be in serious condition. Shivering uncontrollably, the intern mused, “Why’d I enter that darn radio contest? I should...have just stuck to medicine. I think I’m going to...forget about flying a pl....” Morton broke off as a fresh wave of pain washed over him. He looked at Johnny in desperation as he felt himself slipping away. Johnny watched helplessly as Mike’s eyes rolled back in his head. “He’s out.” he said to the lifeguards who were helping support the doctor. He was grateful to see the fireboat approaching. Chet slowed the boat as they approached, coming towards the scene as carefully as possible. “I need a c-collar and backboard.” Johnny called out as soon as the boat had stopped. “I’ve also got to get his arm splinted. “Compound fracture of his right humerus. We’re going to need a chopper, Cap.” “You got it, pal.” Captain Stanley said as he pulled out his HT. “L.A., this is Engine 51. Please respond a chopper to our location.” After receiving L.A.’s acknowledgment, he leaned over to assist in the rescue. “Holy cow! Is that Dr. Morton?” “Yeah, I’m afraid so.” Johnny answered solemnly. ---------------------------------------------------------------------------- While the others were assisting with Dr. Morton, the third lifeguard crawled into the boat and he and Mike Stoker helped Harold in, too. Roy quickly followed, hoping that he would be able to turn their man’s care over to one of his crewmates and be free to help with Mike’s care. Unfortunately, as Harold tried to put his weight onto his left foot it gave out, sending him crashing to the floor. Stoker’s quick reflexes saved the man from hitting his head on the side of the boat, but Harold’s lower leg lay twisted at an odd angle, clearly broken. Roy dismissed all thoughts of leaving this victim as he promptly knelt by the man’s side and began his exam. ------------------------------------------------------------------ With the lifeguards' help, Johnny got the still unconscious intern strapped to the backboard and splinted his arm. A stokes was lowered and they lifted Mike into it. Then many hands reached out and carefully lifted him into the boat. Johnny scrambled up the boat’s ladder and quickly set about taking his patient’s vitals. ----------------------------------------------------------------- ##Rampart, this is Squad 51.## Head Nurse Dixie McCall and Dr. Kelly Brackett turned from the chart they were looking over and stepped into the hospital’s base station. ##Rampart , this is Squad 5-1. How do you read?## Johnny’s voice announced. “Squad 51, this is Rampart. We read you loud and clear.” Dixie answered. She picked up a notepad ready to write the details of the case on the run sheet. ##Rampart, we have two male victims from a small plane that crashed into the bay. Victim one, approximate age twenty-five, was being supported in the water on our arrival. He was conscious and talking at first but has since lost consciousness. Victim has a palpable fracture of his vertebrae at T5/T6, a compound fracture of his right humerus, as well as a visible laceration on his forehead approximately two-inches long. We’ve extracted victim from the water and are using full spinal precautions. His arm has been immobilized. Vital signs: blood pressure 130/85, pulse 70, respirations 20 and somewhat labored. Patient appears to have ingested some seawater and lungs have definite rales. He's on O2. Stand by for details on victim two.## “Squad 51, victim one, start an IV, D5W t.k.o. and transport as soon as possible.” Dr. Brackett advised.” ##10-4 Rampart, IV, D5W t.k.o. Also, Rampart, please be advised that victim number one is Dr. Morton.## As Johnny revealed this last bit of information, Dixie gave an audible gasp. Dr. Brackett grimaced. He reached out and squeezed Dixie’s shoulder as he said,“He’s stable for now, Dix. You know we’ll do everything we can.” “I know, Kel.” Dixie responded. “What on earth was he doing on that plane?” she wondered out loud. “I think I remember him commenting about winning some contest on the radio that gave him a dozen flying lessons.” ---------------------------------------------------------------------- Twenty minutes later, Dr. Brackett, Dr. Early and Dixie were on the rooftop meeting the helicopter that brought Mike and Johnny in. The other victim, Harold, was now stable and would be arriving with Roy in an ambulance shortly. A soggy Johnny walked alongside the gurney as he gave an update on Mike’s condition. “He’s been in and out of consciousness several times. When he’s awake he seems oriented to time and place, although he’s not quite with it, so to speak.” Once in the treatment room the two doctors made quick work of examining Mike. X-ray arrived almost immediately and soon the two Rampart doctors were looking at Mike’s x-rays. “It looks like Mike has a vertebral compression fracture, Joe,” Kel said grimly, his lip twitching as it often did when he was worried. “I believe surgery will be needed - on his back as well as his arm.” Joe stated. “Unfortunately, I concur.” Kel then turned to Dixie and requested, “Dix please call the O.R. and tell them we need to bring Mike up STAT.” “Right away, Kel. Orthopedics just called. Dr. Johnston is on his way.” Dixie said as she picked up the phone. Kel and Joe turned their attention back to Mike. Once again conscious, he asked through chattering teeth, “Kel, how bad is my back? Level with me please.” Placing his arm gently on his colleague's good arm, Kel looked him in the eyes and spoke reassuringly, saying..... -------------------------------------------------------------- Photos: None. ******************************************************** From: Rampartbase Date: Thu Jun 21, 2007 10:17 pm Subject: Completion "We'll know more after we get an ortho to look at these x-rays." Kel replied. He had Dixie call the surgeon to meet them upstairs. ------------------------------------------------------------------- Photos: None. ------------------------------------------------------------------- From: "patti keiper" Date: Thu Jun 28, 2007 5:53 pm Subject: All for the sake of money... Roy DeSoto and Johnny Gage got back from the hospital as soon as they could. They tried not to think about Dr. Morton's injury. The plane crash had been serious, and both of them knew the outcome didn't look good for the future. "Hey, Roy." whispered Johnny, as he concentrated on wiping down the chrome of the rescue squad. "What you think his chances of developing paralysis are?" "I don't know. I guess that all depends on what they find in the x-rays." Roy shrugged. "I guess you're right." said Johnny. "I just wish I could've been there before he went into surgery. I wanted to tell them a few things more. And to, you know, offer him a word of encouragement or two." said Gage as he rubbed both of his red eyes and sighed deeply. Desoto looked up and watched the cars whiz by down the avenue through the open garage door. He kept imagining that there was something that they could have handled better during the rescue, but each time, Dr. Brackett's reassurances that he still remembered, refuted any blame for that. Captain Stanley came out of his office with some paperwork and looked at both of them. "I know you guys are still down about this, but dinner's almost ready." Gage startled, whirling on his feet. "Oh, okay. We'll be right in." Johnny put his hands in his rear pockets and slowly headed for the kitchen. "Uh,...Roy, did you hear that?" DeSoto still scrubbed the top rack chrome with a vengeance bordering on frustration. He didn't look up. "Roy, chow's on." Johnny said again, rapping on the side of the squad a little louder. DeSoto blinked a few times. "Lunch already?" Still numb, DeSoto slowly followed in his partner's footsteps.:: Why can't I get this rescue out of my mind?:: he thought.:: It's not like Mike was dying or anything.:: he reasoned. Then another part of himself gave the answer.:: It's because you know him, stupid.:: The rest of the gang set the table quietly. Most of them had already showered off the sea salt itching their skin. Marco saw the expression on the paramedics' faces and pushed the plate of chicken in front of them first. "Dig in, fellas. I made plenty." he said with a forced cheerfulness. Both Roy and Johnny nodded, and took their share reluctantly. Captain Stanley slammed down his fork, with a bang. "Well, is he going to get better, or isn't he?" Both Johnny and Roy flinched. "Dr. Brackett seems to think that he's going to be okay." Johnny replied. "W-We know that he's in surgery, and that his vital signs were stable when we left him." "Well then, why the long faces?" Chet Kelly asked. Gage picked at his food. "It's just really hard, you know, when you know your victim." "That's exactly it." Roy emphasized as he played restlessly with his napkin on the table. Marco Lopez tried to lighten their moods by throwing a piece of chicken at Henry. "Here you go, boy." When the brown and white hound dog caught it, he celebrated. "Hey, hey!" He looked up with a smile but found that he hadn't cheered up anybody, including himself. Mike Stoker took a long swallow of his milk, and then he took a big breath. "I don't know about any of you but as soon as soon as we're done eating, I'm going to give Dixie a call right back." Hank Stanley jumped on the suggestion. "Now that sounds like a plan of action, the best one I've heard all day." "I guess so." whispered Johnny, slowly buttering the potatoes on his plate with a knife. Over on the couch, Henry the dog whined. He didn't know what was going on, but something wasn't right with his human gang, and he wasn't about to be quiet about it. Yawning nervously, he jumped down and made a beeline for Roy and Johnny's legs. Snuffling loudly, he began to rub his snout back and forth across both their pairs of shoes. It finally worked. A smile cracked out of both of them. The two paramedics began to relax. Johnny managed to snatch up a chicken leg, and he bit into it with an appetite. Stoker smiled. "Guess you did all right with my recipe, Marco. It's not going to waste." he quipped. Roy finally had to laugh at that, and he almost choked. Johnny Gage shot up out of his chair. "I'm fine! I'm fine!" Roy told him, coughing up some food. "Henry just bumped me." "Are you sure?" Gage asked, still not believing him. Roy nodded, still sputtering. Captain Stanley eyeballed them both with a close look. "Do I have to tell you pipe down?" "No,.." chuckled Chet. "He needs to pipe up." The joke was lost on Cap. He just kept shoveling in his dinner like there was no tomorrow. "Yeah, well, anyways, there I was with my arms full of this guy's stretcher, right?" Chet Kelly said eagerly. "And the waves kept coming, and coming. I thought we were never gonna get out of there. But you guys did a swell job and everybody was okay, and that's the important thing, so quit moping. Right, Henry?" Henry barked once with emphasis, as if agreeing with him. Captain Stanley swallowed his last mouthful and quickly got up and left the table. He rushed over to the TV set and turned on the news. Rampart Hospital was the subject matter. And that took the entire gang by surprise. Gage almost spit out the meat in his mouth. "What's going on over there now?" he cried indignantly. "Another brushfire?" Cap was actually stunned. "I haven't the foggiest clue. But I promise you I'll find out in seconds." The gang was riveted by the scene showing on the TV set. A milling crowd surrounded the emergency entrance, with picketing signs. They could just make out some chanting. ## No more work! Too little pay! No more work! Too little pay!## The sight brought Roy and Johnny to their feet. "Just what the h@ll is going on?!" Gage demanded chipmunk cheeked. Roy's mouth flopped open. "Looks like a surgeon's strike or--" Johnny Gage barged ahead of all of them as they clustered around the TV set. As they got closer, it was clear that the uniforms people were wearing, were surgical blue, and not nursing white. The phone on the wall started to ring urgently and Roy DeSoto was the closest one to pick it up. It was Dixie. ##Roy, have you heard yet? They're med-evacuating everybody who's scheduled for an operation today to other hospitals. It looks like their AMA union negotiations fell through.## "My G@d. Is that happening to Mike Morton?" ##Yes. He was one of the first ones to go. He's on the way to Mercy right now.## Desoto frowned. "Is there anything we can do?" Dixie sighed angrily in his ear. ##Don't I wish you could! But even Dr. Brackett's hands are tied. The orthopedic surgeon he had all set for Mike, was forced to stop scrubbing up by an angry mob.## "Um, okay, geez, this is awful. Could you keep us posted with how he's doing?" DeSoto asked. ##I sure will, Roy. Gotta go. Bye.## "Goodbye." Roy hung up the phone in total shock. He rejoined the others and sat down in his chair numbly. "What was that all about?" Kelly asked. "I'm afraid it isn't good news." DeSoto told them. Gage sat up a little straighter from where he was slumped. "Is it Dr. Morton?" "No. I mean, yeah. Uh, sort of. You see, his surgeon's debunked. Apparently, there's a doctor's strike going on that's just begun. That was Dixie just now, filling us in on all the nitty-gritty." Roy sighed in frustration. "Let's just hope we can-" Gage began. The tones went off. It was a call for the entire Station 51. Disturbed beyond words once again, the gang made for the trucks. L.A. County Dispatch sounded out a big one. A minute later, they were ready, and on the move with lights and sirens blaring. ------------------------------------------------------------------------------------------------------ Photo: An ambulance rushing down the street. Photo: Dixie and Brackett in the nurses' lounge. Photo: Engine 51 leaving the station. Photo: Cap and Marco Lopez not looking happy. *************************************************** From : patti keiper Sent : Thursday, July 5, 2007 8:22 AM Subject : Like Well Oiled Machinery.. Station 51 was a half-mile away from the scene, when they spotted the smoke plume. "That's big enough to be a fully involved house." muttered Cap, as they drew nearer. "You're probably right, Cap." said Kelly. "That's the new housing development at the edge of town." Mike Stoker drove the Ward LaFrance swiftly down the boulevard towards their destination. Engine 51's sirens ground down to a halt as they pulled up in front of the yard. It looked like an explosion had just occurred. A woman wearing a skirt was lying on her back near a running garden hose. She lay amid blown debris, and she was bleeding from a cut on her forehead. "Check her first." ordered Cap, as he opened the door of the engine and got out. Then he thumbed the mic on the radio. "L.A., Station 51 is on scene. We have a fully involved two-story wooden structure. Notify the gas company and electrical utilities to shut down service at the corner of 17th and Maple. L.A., respond a second alarm to our location." ##10-4, Engine 51.## New SCU tones began to fill the air as additional assistance was summoned. ##Truck 127, Engine 18. Respond with Station 51....## Johnny Gage and Roy DeSoto pulled on their turnout coats rapidly. Marco Lopez snatched their medical gear out of the squad as the two of them knelt on the grass next to the fallen woman. They kicked the running garden hose water stream, away from her face. Roy reached for her carotid. "She's alive." Leaning over, he peeled back one of her eyelids. "Looks like a head injury only. She doesn't have any obvious burns anywhere." Nearby, Cap began to issue orders. "Marco, Kelly! Get out two inch and a halves and start tackling the north and east exposures from upwind." "Right, Cap." they replied. "How is she breathing?" asked Johnny, opening up the biophone. "Fair." replied Roy as he opened her airway a little wider with a modified jaw thrust. "I'll get the 02." said Stoker. Weak coughing got Roy's attention. The young woman in his hands was waking up. "Easy. Easy. I got you. Don't try to move around too much, you've been in a fire." "Oh, *gasp* I-I tried to-... but I- *cough* They- *choke*" blinked the woman groggily. Johnny scrambled over to her side with the resuscitator mask. "Here, breathe some of this in. It'll help you wake up a little faster. How's your head?" The woman didn't reply, and she started shivering. Mike Stoker began to cover her up with a shock sheet. Her limbs began to twitch, and she groaned, lapsing half unconscious again. Roy gripped the sides of her face, making sure to keep her neck still, in the same position he had found her in. "Hey, can you hear me? Open your eyes!" he shouted loudly. The woman only choked weakily. Johnny began to ventilate her when she didn't breathe in adequately to his liking when she fell still again. "I got a bad feeling about all this." said Johnny as he inserted a short oral into her mouth. "How much do you want to bet that somebody's still inside the house? You can let go. I got her." he said, repositioning the demand valve over her nose and mouth firmly. Roy looked up from where they were working. "Hey, Cap! We think she's not alone!" shouted DeSoto as he pulled out a stethoscope from the I.V. box. From the street, Hank looked back and nodded. "Chet, drop your line and get into scba. Truck 127 can take over on that side as soon as they get set up!" he said as he heard sirens approaching. "Search the house!" Chet Kelly ran for the engine and the storage compartment. He also grabbed out a safety line. He got into his air bottle and tied the end of the rope over his waist belt. Captain Stanley left the street and ran with him to the open door of the hot, rapidly burning house. "Make it fast." Stanley told him. "I don't know how much longer that roof will hold." Kelly smiled through his mask. "Time for another race? I'm up for it today." "I got your back. Go ahead. And keep your HT on at all times." Captain Stanley patted Chet on the shoulder and told him he was set to enter. Cap picked up Kelly's line and wrapped it around his gloved wrist. "Whatever you do, don't let go, Cap. Keep feeling for my tug." Chet said as he disappeared into the smoke. ------------------------------------------------------------------------------------------------------------- Inside the house, flames and burning wood crackled all around him. Chet was reduced to feeling his way around on top of the steaming, incinerating carpeting crawling on his hands and knees. He began shouting. "Hey, can anybody hear me?!" The heat was intense. Instinctively, Chet chose the first hallway to the right. Kelly shouldered his way through the next door, using the weight of his bottle as a battering ram. Immediately, he heard the cry of an infant. And the groan of an older male, to his left, inside the bedroom. "Get us out! Help us! Please. *cough* *cough*" croaked a grandfather. In his arms was a wet blanket wrapped around a tiny baby boy. "He's hardly moving anymore." Kelly reached for him. "Can you follow me out?" he said as he set his mask over the baby's face. "I-I think so." he replied blinking sharply in the smoke. "Who else is home?!" Chet demanded, gripping his arm. But the older man didn't answer him, deafened as he was by the din of the flames. "Okay, stick close behind me. We're going out the front door!" he promised him. "If you get lost, just follow the rope until I come back for ya." Breathing heavily, Chet brought his HT up to his face. "HT 51 to Engine 51. I found two victims. We're on our way out the front door now!" ##Any others?## asked Cap. "I'm not absolutely positive. An adult male senior's too shaken up to answer much." replied Chet as he curled protectively around the baby. ##Make tracks then. I've got Mike waiting outside with plenty of oxygen. Hurry it up a little. ## Chet barely made the front door when a sudden collapse nearly pinned him on the porch. Captain Stanley had to literally pull him clear by the arms. "Next time, hurry when I tell ya to hurry." Hank grumbled at him. "Thought I was hurrying. Maybe it's just a faster fire." he quipped. Hank had to grin as he helped his man back onto his feet. ---------------------------------------------------------------------------------------------------------------- DeSoto looked up after he had fastened the last strap on the young woman's C-collar. She was awake now, and crying. He saw a commotion at the front door as Chet and Stoker met each other and traded off a baby and an old man to other firefighters. "Johnny, it looks like we're getting an infant, too." Gage's head snapped up from where he was starting an I.V on the girl. "Wha- Uh, okay. This is done. Brackett wants her head elevated if she's not feeling any pain past that forehead." Roy nodded, quickly finishing his notes. "I'll relay their vitals sets to Rampart as soon as we get them. Cap, could you watch her for a minute?" he asked 127's head fireman. "Sure." he replied, and he moved to squat near the blanketed girl as he supervised his men under a watchful eye. Johnny rose to his feet and intercepted the soot covered grandfather. He was walking well, but smoke had made him hoarse and unable to talk. Gage sat him down, and got him into an oxygen mask. "You okay?" he asked him. The silver haired man nodded gratefully, leaning up against a tree. "All right. If you get dizzy, just let that fireman right there know, and he'll help you lie down onto the ground before you faint." he said, pointing to Marco, who knelt behind the old man to monitor his condition. The grandfather was fidgety, his eyes alarmed, and the firm grip that he had on his crying grandson's blanket, tightened a bit when he saw the woman lying on the ground. Roy smiled, seeing a family resemblance. "Hey, don't worry about your daughter, she's doing fine now. It sure looks like she did everything she could to get the two of you out of the house until we got here." he told him. The old man started weeping when a neighbor rushed up and held him close in comfort. DeSoto gave her a gauze pad to tend to his minor scrapes and spark burns. "Relax, sir. You can keep holding the little guy if you'd like." DeSoto told the grandfather. "Here, take this, and hold it over his face while I check him out. Mister? Really, he's okay. His color and reactions are sittin' real good." DeSoto said as he showed the older man how to hold the tiny pediatric oxygen mask in his gnarled fingers for the fussy baby to use. "M-Marsh-a..?" the old man rasped, coughing. "Is that your daughter's name?" Roy clarified, pointing to the younger lady. The grandfather nodded, trying not to jostle the baby as Roy gently pulled off the infant's clothes to look for hidden injuries. He found a word embroidered on his pajamas. "Is this Joshua?" Again, the nod. "He's big for his age." DeSoto said. "What is he, about three months?" Panting, the grandfather held up two fingers, closing his eyes in relief as the oxygen he was on started working to alleviate his shortness of breath. "Okay, I'm going to take his blood pressure. Then I'll get yours right afterwards. Keep resting a bit. Are you feeling any chest pain at all? Any other discomfort?" Roy probed. The tired man shook his head lightly as he accepted the grip Marco gave one of his hands when Lopez started taking his pulse. "Okay." DeSoto replied, beginning his secondary survey on Joshua. The baby's eyes tracked his easily and he made a disgusted face when Roy wiped away a ball of mucous from his nose with a gauze pad. He let DeSoto know about how angry he was with a loud squawl. "I'm sorry.. Wow, a great pair of lungs. I promise I won't do that again." he teased the grandfather. Nearby, Marsha was slowly seated upright with Johnny's help. "H- How's my son doing? And Pa?.. T-They were both in there a long time." she gasped. "They're better. Now, how much do YOU remember happening? We found you unconscious, lying in the front yard." Johnny told her. The woman flinched when Gage started wrapping the gaping wound on her head. "Everything. Uh, that is, until right up to when the explosion happened. Oh, Pa, I'm so sorry. I knew I should have had that furnace fixed the minute it started having trouble lighting up. Dan's gonna kill me." she said, trying to see around the collar she was wearing. Gage smiled at the interchange and the mention of an irate husband. "Was it just the three of you at home?" he asked, getting Cap's glancing hint to double check that fact at once. "Nobody else is still inside that fire, right?" "Yeah... yeah. No one else. My husband's at work." Marsha said, then she watched as the roof of the house caved in slowly, getting eaten by tall flames. "Oh, no. And we just built that house two years ago." she winced, more at the collar than at the headache that was just beginning. "This, is gonna cost us... a fortune.." she puffed in dismay, tearing up again. "Oh, my eyes. I can't see very well." "Is your vision being effected?" Gage asked her. "No, I...It's I just got soot in them, that's all." Roy smiled."We'll take care of that and rinse them out for you. Won't take long." "All right." Marsha said. "But I'm still not happy." she frowned. "Insurance is great nowadays. I wouldn't worry about it." Kelly said, taking off his scba gear. He jogged off to grab a hose behind a team from 127 to help them out with their frontal attack. Stanley turned away, satisfied. He lifted his radio. "L.A., This is Engine 51. All units out one hour. Respond an ambulance to this address, Code 3. And please send a second for our fire as a stand by." ##Engine 51.*Spap*## DeSoto got on the biophone. "Rampart, this is Rescue 5-1. How do you read?" ##Reading you loud and clear, 51. Has your female patient's status changed?## "That's affirmative, Rampart. Conscious, alert and oriented time three. We also have two new victims, rescued from a burning house. Victim Two, an infant male aged two months, suffering from mild to moderate smoke inhalation. Pulse is 140, respirations are 30, emotionally distressed. No burns are evident. BP is 92 over 50. Victim Three is a male, in his mid to upper sixties, conscious but mildly dyspneic, with signs of vocal hoarseness from exposure to wood smoke. He has numerous minor cuts and abrasions about the face and neck. Vital signs are: BP is 152/110, respirations are 20, pulse is 122. Both victims are on 15 liters of O2." reported DeSoto. ##10-4. On Victim Two, if he's showing signs of dehydration, go ahead and inject a normal saline bolus of 20cc I.V., monitor him closely for signs of increasing breathing difficulty. On Victim Three, I want an EKG strip, Lead 2, that's strictly precautionary given his apparent age and current condition. Start the adult male on an I.V. D5W, TKO and continue to monitor his vital signs in transit. Get a full medical history on all three. What's your update on Victim Number One?## Johnny took the phone from Roy. "Rampart, she's talking coherently and not complaining of any neck or back pain from her fall to the ground after getting knocked out by that flying debris. Shall we keep her in the collar?" ##That's affirmative, 51. We need to x-ray her first to rule out any possible cervical spinal injury that might be associated with her recent concussion symptoms. If she refuses a spine board when the time comes, that's her choice. Document everything she decides from here on out concerning any further medical care, in detail.## said Kel. "10-4. Documentation, Victim One. 20 cc bolus N.S. for Victim Two on signs of dehydration, Victim Three, send a strip and an I.V. D5W, TKO. This is Lead 2, Rampart.." said Gage, adjusting a dial on the biophone after Roy completed setting up the connections. "Reading.. mild sinus tachycardia with minor ST segment elevation." he reported. ##I concur, 51. No gross ectopi in evidence. That's what I was looking for. Okay, go ahead and transport, Code 3, for all. What's your approximate time of arrival?## "Six to eight minutes, Rampart." Johnny told him. "Once they're loaded up." ##Sounds good. We'll be waiting with a pediatrician and a respiratory specialist for the baby.## "10-4, doc. Squad 51, out." said Gage, hanging up the phone. "Okay, let's go." he told the others surrounding him. A piercing whistling got everybody's attention. It was Cap, grinning from ear to ear. "Hey, look! At least somebody's having fun here today!" he shouted, pointing. Roy, Johnny and their patients spied a straying neighbor dog, who was dead set on conquering the fallen garden hose's water stream, completely obvious to anything else. Kelly crowed. "Good boy, good dog.. Bite the water. Come on, go get it!" he encouraged the ferociously playing canine. "Man, Cap, we oughta recruit him. He's quite the fire dog already." Chet quipped, giggling like a banshee. "Look at him go!" His mood, was infectious and the rest of the afternoon's cleanup, seemed like nothing at all, afterwards. ------------------------------------------------------------------------------------------------ Photo: Woman down by a hose outside. Photo: Cap, intent by the engine. Photo: A burning house in daylight. Photo: Marco and Johnny working on a victim in air bottles. Photo: Cap and Chet attacking a porch fire in scba. *Animated Gif* : A burning room in darkness. Photo: Girl with a cut being tended. Photo: An EKG strip, showing V-tach. Photo: A baby receiving oxygen in a mother's lap. Photo: A woman caring for a tired, injured old man. Photo: Roy in full turnout, on the biophone. ************************************************** From: "patti keiper" Date: Thu Jul 5, 2007 6:31 pm Subject: Water Versus Salt.. It was early evening. Joe Early silently met with Kel Brackett at Dixie's desk and together, they mutually nodded at each other without speaking to meet inside Kel's office on a consultation. A very special one. Kel wasted no time in grabbing the patient files that Joe handed to him that he himself had just retrieved from the heliopad paramedics who had been returning Mike Morton from his concluded surgical procedures at Mercy General back to Rampart's own ICU unit. Kel was impatient. "What did they find on his arrival?" Joe read an entry on the top file. "He was doing fine then, Kel. His saturation while on supplemental oxygen and continuous positive airway pressure was 98%. Eyes normal. Pupils equal and reactive. Neck supple. Heart regular. His lungs had spontaneous respirations with the same bilateral wheezing and rales that we had noted earlier. A good air exchange. His abdomen still presented as benign. And all of his extremities, even with that humerus fracture, had good pulses and perfusion. He came through the surgical repairs with flying colors." Brackett's face was iron. "Well, then, what the h@ll happened?" he demanded. Joe's face was as tortured as Kel's. "Kel, your guess is as good as mine. According to these records, Mike's cardiac and pulse oximetry monitors were placed. A Foley catheter and nasogastric tube were placed. 200cc of fluid was evacuated from Mike's stomach. His initial arterial blood gasses were: pH 7.11, pCO2 27, pO2 140, bicarb 9. Electrolytes were: Na 125, K 4.0, Cl 92, bicarb 11. His glucose wasn't grossly abnormal at 245, considering the stress he was under. His white blood cell count was 29,500 with 5% segs, 1% bands, 92% lymphs. Again, a directly related outcome brought on by the stress of the rescue. But most conclusively, he wasn't bleeding out like we all thought. His Hgb was rock solid at 12.3, Hct 35.8, and his platelets were a healthy 394,000..." "Joe! Somebody went wrong somewhere on spotting this and I want to find out exactly who was responsible and how this clearly developing adverse condition was missed!" Brackett roared. A knocking at the door interrupted them. Startled, Joe quietly shut Dr. Morton's files and placed an opened newspaper over the top of the stack so the name wasn't visible. It was Dixie. She smiled falsely, knowing that she had barged in on something else very serious. "It's Roy and Johnny, fresh off another fire. They're asking about Dr. Morton. So,..will you tell them? Or shall I?" Her eyes flashed additional warning. That sobered Joe and Kel right away. Brackett's face twitched. "We'll both see them, ourselves. They played a very active part, Dix." he said softly, leaving McCall alone with the files. "I don't want them to have to learn about Mike's current status on their own. It wouldn't be right. Somebody would tell them eventually, and they'd do it in the worst way possible. It's better if Joe and I break the news first." "Want me to come?" asked McCall gently, fingering the edge of the hidden files. "It's your call." Brackett said, lightly rubbing her arm to comfort her out of tears. "I won't force you to do anything that you don't want to do." Dixie said nothing directly, but she went out with the two doctors, leaving the office door to swing soundly shut. ------------------------------------------------------------------------------------ "Hiya, docs.. Dixie..." beamed Johnny. "Man, did we kill two birds with one stone. A family saved in the afternoon, and a whole apartment complex this evening. We're batting a thousand!" Roy's smile was equally joyful. "Yeah, and in the end, nobody got hurt." The two paramedics laughed openly and long, until they saw the fallen expression on Dixie's face and the glimmer of unshed tears. The two grins on DeSoto and Gage's faces wiped off suddenly, sharply, and the change almost injured the two doctors standing on either side of Dixie. Finally, Johnny spoke into the silence, "What..? Uh, is this about Dr. Morton? Dixie, why are you so upset?" Roy broke in, nervously. "I mean, he is all right, isn't he? The surgery at Mercy was successful?" Quickly, the doctors nodded their heads in the positive. "The surgery went fine. Uh, just fine." said Brackett. Roy was firm, even though his face was blank. "Well then, why the long faces? If there's anything that you gotta say, why don't you just come out and say it? We're both big boys nowadays playing around with fire trucks and all." he tried to joke. "If it's serious, we won't--" "It IS Mike." said Dixie. "I'm afraid he's the one in seven, Roy." Gage voice was muted, almost flat. "W-What exactly do you mean by that statistic. It could mean just about anything." he flared, getting angry. Dixie sat down on her desk stool. And Brackett and Joe leaned over the counter top. "Keep your voice down, and I'll tell you. Everything." Kel said, defending her. Roy pushed away the coffee cup that suddenly didn't taste good to him any more. Johnny did the same, whirling, until his back was to Kel and Joe as he listened. He cocked the actively chattering HT onto a shoulder for some moral support and he bowed his head when Dr. Brackett began speaking. "When he was driven to Mercy, Mike was treated with sodium bicarbonate for his metabolic acidosis, aerosolized albuterol for that wheezing you two found, and... furosemide for newly developing pulmonary edema." "Secondary drowning?" Johnny quailed, turning back around. He set both hands on the countertop to steady himself. Joe hung his head and played with the silver rings on his fingers. "The latest CXR shows small patchy basilar pulmonary infiltrates and he's deteriorating rapidly as his PE and small airway dysfunction, worsens. If we can't halt the atelectasis and loss of surfactant in his lung tissues, there may be an even worse pulmonary inflammatory response 24-48 hours after the initial insult." Early said sadly. Gage's mouth flopped open. "But we-- we got to him fast, doc. Very fast. H- He never quit breathing on us." he insisted. Roy thought hard on the prospects. "Sometimes, it only takes a mouthful, Johnny." he said, his eyes stinging. His eyes fell on Dixie, who stood ram rock still. She was trembling. "What else aren't you telling us?" he asked in a whisper. Brackett finally got mad, a silent, raging, barely reined in fury at the facts. "Hypernatremia may occur if enough salt water has been swallowed." Roy angled his chin. "What's that? I-I've never even heard of that before. Is it something we might see on the str--?" "No, Roy. Never on the street. Only later in near-drownings that have had the luck of reaching the hospital in time, though a fat lot of luck that'll prove to be." Brackett growled. "This condition can cause cerebral edema, renal failure, infection, disturbance of electrolytes, acid/base imbalance and decreasing lung function. Treatment is mainly aimed at preventing cardiac arrest." Gage was calm now, listening close. "What do you mean...cardiac arrest? Morton's EKG was fine!" Brackett crumbled and couldn't talk, instead, he busied himself with straightening up patient slates that didn't need to be straightened. Joe did the talking. "In salt-water drowning, aspirated water is saltier than body fluids. So water leaves the blood and enters the lungs to help dilute the salt." "We know that part, doc. That's why we bring em in so fast, right?" Roy asked. Early nodded. "But sometimes, the air in the lungs mixes with the fluids and forms a frothy foam, which acts as a barrier to oxygen exchange, this rare side effect can occur within four hours of near drowning and can turn into full blown ARDS soon after." Gage closed his eyes in horror and sadness. "Acute respiratory distress syndrome? Is that what he's got going on right now?" Kel finally looked up and met him in the eyes. "I'm afraid so. Things aren't looking so good." "How so, doc? I mean, if it's just a matter of outwaiting the fluid build-up in the lungs..." Roy began. "It's more than that, Roy, much more." said Dixie. Joe elaborated. "A patient will often require intubation with mechanical ventilation. And Mike was already on assisted P.E.E.P. because of going through his back and upper arm procedures. His ARDS has progressed to the point that inflammatory membranes are forming around all of his aveoli sacs. Right now, he simply can't breathe through his lungs normally and get enough air. He's requiring very high amounts of oxygen and pressure to get that oxygen into his tissues which in itself can further damage the lungs with--" Roy sighed, a painful sound. "...barotrauma and oxygen toxicosis." Joe nodded. "Once a person gets ARDS, the mortality or death rate is upwards of 50%. ARDS can be caused by many things besides drowning such as smoke inhalation, other serious infections like aspiration pneumonia.." Kel added more. "This is a ...final pathway that any pair of damaged lungs might eventually take. Anyone who actually recovers from ARDS can easily be considered...a- a miracle." he sobbed. Gage struggled to talk. "Well, can.. can we see him?" Roy nodded, chewing on a fingernail nervously, whole heartedly agreeing with Johnny with a like nod. "Sure. I can't stop you. In fact, I'll waive all visiting hours for the both of you." Brackett told them. "You can come see him anytime you want. In fact, I'm personally not leaving his side, until all of this is over." Dixie came over to Brackett and kissed him on the cheek before she hurried away to hide her growing fear with the numbing distraction of work. ------------------------------------------------------------------------------------ The ICU room was full of noise, with the sounds of ventilators, EKG and blood oxygenation monitors and a bubbling humidifier attached to the wall. Johnny and Roy were almost reluctant to enter, but Kel went right in and started a running strip off the heart monitor. "So far so good. He's still a little tachy and hypotensive, but we've managed to stave off any serious arrythmias with a course of bicarb to minimize his metabolic acidosis." he explained. Gage took advantage of the doctor to paramedic talk. "What else are you doing?" he asked, his expression flat and calculating as he ran all the facts he was gathering from the machines through his head. Kel frowned. "We've started another I.V. slightly less than maintenance to prevent further pulmonary compromise. And I'm considering antibiotics for his aspiration of contaminated seawater." Johnny pointed to a lab result sitting on Mike's table tray. "But what about this? He's up to 34,000 now." "That leukocytosis is a common stress response and is not indicative of infection." Brackett told him evenly. "It's too soon to see signs of that yet." "Why the bicarb?" Roy asked. "He never arrested." Kel was frank. "As Mike's oxygenation improves, his acidosis will also resolve, hopefully. And his heart will become less and less likely to stop as time goes by. We've placed an NG tube to prevent aspiration and to keep the stomach decompressed. Excessive contents could elevate the diaphragm and restrict thoracic volume. That bicarb was just to hurry the process along a little faster." "More space means more breathing surface.." Gage reasoned. "Yes." Roy circled the bed, not resisting the urge to feel for Mike's thready pulse at one of his wrists. "Is there anything you can do for that rising hypernatremia? He swallowed an awful lot of seawater. How will it effect him if you can't get his blood saline levels back down to normal right aw--?" On the bed, Morton's body arched into a seizure, upsetting the endotracheal tube's connection to the automatic respirator. Johnny and Roy threw themselves at his head to steady it long enough to connect an ambu bag to the end to keep manual breaths going into his lungs. DeSoto hit the crash cart code blue button on the wall with his elbow. From out in the hall, Kel heard the sound of nurses and the attending running towards them down the corridor. ##Code Blue. Code Blue.. ICU 4. Code Blue..## came the overhead announcement from the operator. Kel held both of Morton's arms as he lowered the bed to level with a foot pedal. "Johnny, get 10 mg diazepam! Stat. It's in the crash cart. Top shelf!" "I got it.." said Gage, hurrying to bleed the needle of air. "Where? ET or I.V." "I.V... Push it. We have to end this seizure now." snapped Brackett. Intently, Roy and Brackett watched the cardiac monitor as a crush of premature ventricular contractions began to intercede in between the normal intervals on the monitor. "No.. Mike.. no.. Settle down.." Kel muttered under his breath as Gage delivered the powerful sedative. Emergency staff flooded into the room and jumped at every order Brackett gave them. A minute later, Morton fell out of his seizure and his chest began to rise in response to being ventilated actively. "He's set, doc. Where do you want the P.E.E.P.?" Johnny said urgently, still squeezing the ambu bag connected to Morton's breathing tube. "His PO2 is 86% on the oximeter." "Set it at 5-10 cm of positive end expiratory pressure." Kel ordered. "Got it." said Johnny. "Seven cm, at twelve a minute." The noise of Morton's racing heartbeat on the audio alarm began to slow.. 140, 130,..100. Brackett ordered more labs. "I want a urine osmolality and sodium levels asap. And call up a radiologist. I want a full head CT and imaging MRI study done once the labs are collected." "What caused that convulsion? He was calm, resting.." said Gage when Morton was stabilized. Kel sighed, still sweating from every pore. "Acute hypernatremia often results in significant brain shrinkage, causing a stretching of bridging veins and arteries between the two cerebral hemispheres. This can result in subdural hemorrhaging." "A stroke?" Roy asked incredulously. Kel simply nodded, keeping an eye on the oxygen percentages reading off of his friend's central line. "How high can the salt get before it does permanent damage?" asked Johnny. "Serum sodium levels of 150-170 mEq/L usually indicate dehydration. That we can fix. Anything over 180 mEq/L results in permanent CNS impairment." Brackett told him. Kel drew out a syringe from a special drawer in the crash cart that they hadn't used. "What's that?" Roy asked. Brackett's face was intent and lost in hard thought. "Possibly the only thing that might save Mike now. I'm giving him Vasopressin. 5-10 Units I.M. SQ three times a day, as needed. Duration of action is approximately 3-6 hours. This will bring out more water from his body cells to help carry that excess salt so it can be excreted out of his kidneys more rapidly. A short half-life lessens the risk of acute water intoxication and this makes it the ideal treatment for him." "And if that doesn't work?" Roy asked. "We'll try a combination of diuretics and a D5W infusion. If that fails, I'll risk dialysis. On second thought, Johnny, start him on a 250 ml/h drip D5W. Let's not wait for that piggyback aid." A half an hour later, Roy, Kel and Johnny were still working over Dr. Morton at his bedside, when the tones went off. ------------------------------------------------------------------- Photo: Brackett standing by a crash cart. Photo: Roy looking stunned at Rampart. Photo: Johnny looking stunned at Rampart. Photo: Joe Early getting mad. Photo: Dix and Kel studying each other, serious. Photo: A Code Blue button. Photo: An Ambu bag being lowered onto your face. Photo: A surgically naso-intubated man getting bagged. Photo: Kel and Joe looking down onto a bed. Photo: A syringe full of medication in close up. Photo: Roy getting a rescue call by HT at Rampart. *************************************************** From : Cassidy Meyers Sent : Friday, July 6, 2007 6:34 PM Subject : Cause and Effect.. ##Squad 51, with Engine 51. Respond with L.A.P.D. at the amusement park. Unknown type rescue. 1780 Santa Monica Boulevard. 1780 Santa Monica Boulevard. Cross street, Caine. Time out: 20:22.## "Doc?" Gage asked. "I'll keep you posted." said Brackett, as he looked up from where he was listening to Mike's breath sounds with a stethoscope. "Thanks for all your help." "I'm glad we were here." said Roy as the two of them started for the intensive care room's outer door. "So am I." said Kel. "Would you send Dixie in? I need her." "First thing." said Gage, he lifted his handy talkie. "L.A., Squad 51. Responding from Rampart General Hospital." ##Squad 51.## The two paramedics departed reluctantly. As they hurried through the busy halls, weaving in and out of the crowd of patients and staff for the Emergency entrance, Roy bit his lip. "Boy, I sure hope Dr. Morton makes it." Johnny was sharp. "Quit being stupid. What makes you sure he won't?" DeSoto hit the open button on the receiving door. "Might be a feeling." "Yeah, well. It's a paranoid one if it's anything. You saw the way Brackett was going over him with a fine toothed comb. There's no way he can take a turn for the worse again, without his knowing about it the very same instant it happens. Kinda like how it happened, just now, for us." DeSoto didn't reply and his look spoke volumes. "I hope my instincts are very wrong, Johnny. But he felt like he was dying to me." Gage slammed his door shut as they both got into the squad, and hesitated in putting his helmet on, even as Roy flicked on their lights and sirens to pull away. "Don't say that. Not while he's still got a pulse." he murmured softly. Roy nodded, angry with himself and he pulled them quickly away from the hospital proper. Rampart staff parted like the Red Sea before the squad, but DeSoto didn't see any of them in his eyes. All he could see was the bluish pallor that had been encircling Mike Morton's mouth while they were resuscitating him. ----------------------------------------------------------------------------------------------- "Cap?" Roy hollered as they two of them got out of the rescue squad newly parked next to Engine 51's big bulk. "Over here. And keep under cover!" Hank warned them. Immediately, Johnny and Roy hugged the back of the carnival games booths, as they approached keeping low as they moved towards the sound of his voice. "Now what?" Gage snapped in irritation, trying to keep quiet with their medical boxes as their handles and locks jingled. Hank heard his paramedic and ran over to join them. "Bomb threat." Johnny was dismayed. "Oh, terrific.." he said sarcastically. "Are we here to evacuate?" "The police have already taken care of that. The Bomb Squad's here, with their sniffer dogs. They're looking for a device that might be located somewhere on the pier." Roy rubbed his chin around his helmet strap. "What tipped them off?" "An anonymous pay phone call." Cap said, dripping displeasure. "Placed about twenty minutes ago." "And we're the standby in case that thing's real, and goes off?" Johnny asked. "You got it." said Kelly, looking small as he crouched behind a solid pier piling. "The dock's been cleared up to where you see them making their move." he said, tossing his curly head into the specialists direction. Cap sighed. "Stoker. Go charge up a line, just in case." A dog, under one man's leash, began to whine, straining as it approached a large, chained down wire basket full of trash. "Everybody down!" yelled the detective in charge. "Spike's on point!" Gage couldn't resist, and he peeked around the corner of the building from under the edge of his tipped down helmet rim. "They're about a hundred feet away from us. Out in the open. Right in the middle." Cap and the others took a caution look, too. Hank beat him to his next thought. "Do you think those bullet proof vests and shields are tough enough to decently protect those men?" "No." said Chet. Gage glared at Chet in irritation for jumping in. But he soon sided with Kelly wholeheartedly. "I have to agree with Chet. They look as thin as tissue paper, even from over here." Roy made another observation from where they all pressed against the building, holding their breaths in silent waiting. "Their legs and arms are completely exposed. If they get nailed, any bleeding'll be arterial beyond a doubt." "Don't get morbid." said Cap to DeSoto. "I'm not. I'm just being a paramedic, anticipating the worst, so I'll be better prepared." Roy said seriously. "Ignore him, Cap. He was doing the same thing at the hospital after we visited Dr. Morton." Cap brightened, in spite of the situation. "Oh? How's he doing? Is his back okay?" Johnny cleared his throat nervously as the excited dog was cautiously backed off and re-crated. "It's too soon to tell. Right now, they're concentrating on stabilizing his condition first." "Stabilizing?" asked Marco. "Did something bad happen?" Roy sighed. "Mike had a convulsion. Brought about because of a metabolic imbalance due to a large ingestion of seawater. But he's sedated now, comfortably." Johnny added more."Guys, they're evaluating him for the possibility of having suffered a stroke. They're suspecting the seizure was the first symptom of that." "What?" Stoker whispered. "But Dr. Morton's healthy. I thought he was just a little banged up this morning; nothing that couldn't be fixed easily." "So did we." said Gage. "But apparently, those horror stories we always hear about on the perils of drinking seawater, are true." Stoker was quiet. "What are his chances?" Roy shook his head minutely. "I don't know. Dr. Brackett doesn't know either. And that's got me real scared. He's not leaving Mike's side at all. You should have seen the look on his face as we left, guys. It was--" Johnny watched as two of the senior bomb squad members advanced on the open wire waste basket with a shrapnel shoulder yoke bucket and thick pairs of gloves and leg guards. "You know, I'm really starting to regret every bad thought I ever had about Dr. Morton. His gruff bedside mannerisms aside, he definitely is a good doctor now that I really think about it." he murmured. The others didn't say anything. They didn't need to, each were lost in their own thoughts. And that's when it happened. BOOM!! "Pipe bomb!" yelled the detective, running out from behind his sheltering wall as he watched his two bomb defusing men fall. A cloud of nails and a plume of incinerated propellant coned up around their upper bodies as blast shock took hideous effect. Hank yelled. "Safe?! Is it safe?!" "Yeah! Get 'em in there!" shouted the detective. Galvanized into horrified action, Roy and Johnny ran for the smoking officers lying on the boardwalk. Their hands were raised and fingers frozen, both reaching out in a rictus of pain. Their legs and arms were throughly porcupined with embedded nails and screws. The garbage basket itself was flower petaled open, all of its fresh trash and papers burning with other falling cinders, igniting wood planks all around under a flaming soot fall. Cap snapped out orders. "Mike, Marco, get that inch and a half and put out this fire." He hefted up his walkie talkie. "Engine 51, L.A. Our bomb has exploded. Hazmat danger zero. This was a low-order. Fire containable. Two victims down. Send an additional squad and a beach helicopter for air-evac. Stand by for our patient status in five." ##Engine 51.## Gage shouted."Get stokes and backboards!" The gang rushed forward, wetting down the pier as they hurried to reach the blast victims' sides. Roy dropped onto his knees next to the first who wasn't moving. He lifted the cracked face shield and startled. "Ahh.." A six inch spike had penetrated the special plastic and was embedded sickeningly in between the man's bulging eyes. They stared up sightlessly. "This officer's dead." he said as his probing fingers found the lack of a pulse in his bloody neck. He saw gray matter beginning to drip out of his nose. "He's past attempting." he told the others. "Leave him." DeSoto turned to the screaming man to whom Johnny was speaking. Johnny was quickly exposing areas showing blood. "Easy, easy. Just lie still. You've got punctures all over the place up and down both of your arms and legs and you're bleeding badly from your thigh. Don't move. We're gonna stop it and your pain as soon as we can." "Marve? M-Marve?!" The second man kept trying to reach for the feet of the first. DeSoto grabbed the older officer's shoulders when he saw Marco begin to apply a femoral artery pressure hold. "Hey. Listen to me. I'm sorry. But Marve didn't make it. He's gone." The wounded cop's face fell into lines of grief, shock. "...no. Not Marve.." he gasped, finally accepting what his eyes were telling him. Then he grimaced as the agony of his wounds bore down in sharp focus when the adrenaline he had been experiencing, starting wearing off. Roy held his head as Chet set him on flowing oxygen. "Where else do you hurt? How's your head? Chest?" "Just my legs and arms.." the man sobbed, sweating. "Oh, G*d. Why did we come?" he cried. His detective boss was thunderstruck. Kneeling carefully in the sharp debris, he took his police officer's bloody hand without moving it. "Because you had to, Steve. Lives were at stake. Did you think Marve doubted, even for once instant, that you and he weren't absolutely the best men for the job?! We'll get that b*st*rd who did this. And he'll pay. Mark my words, Steve. He'll pay dearly." Hank sighed when he saw Stoker pull a sheet over the dead man. "L.A. Engine 51. Cancel the second squad. We've one alive, one Code F at the scene. Please respond the county examiner." ##Engine 51. Baywatch is responding to secure your landing zone on the beach three hundred feet south of the pier. E.T.A of Copter Two is five minutes.## "10-4, L.A." Stanley replied. "We'll use stokes and bring him down there using a lifeguard truck." Steve tried to talk, but pain made it impossible and he cried out as numbness swept down his left leg. He lifted his head and saw that the paramedics were clamping off part of its circulation with hemostats, probing a gaping wound cratering around an embedded nail stuck in at an angle near his groin. "How ba-- bad is it?" he finally managed. Roy looked up. "You won't lose the leg. The main artery's only nicked and this nail's no longer a danger. It's in a bone. Lie back and keep still. Our ride to the hospital's on the way." Johnny Gage stayed on his feet to avoid red hot pieces of steaming metal. ##Rampart, this is Squad 51. How do you read?## he hailed over the loud noise of Stoker's hose as he snuffed out the last of the fire sputtering on the planks around them. It was Joe Early who answered the biophone. ---------------------------------------------------------------- Photo: Station 51 on the Santa Monica Pier. Photo: Police with bomb dogs. Photo: Johnny and a detective in ballistics gear. Photo: Pipe bomb going off in a bomb squad man's face. Photo: Stoker hooking up a fire hose to Engine 51. Photo: Cap and Johnny kneeling, talking in scba. Photo: A man talking with blast effect burns. Photo: Joe Early on the biocom in the base station. ************************************************** From : Patti or Jeff or Cassidy Sent : Wednesday, July 11, 2007 2:16 PM Subject : Aftermath.. ##Go ahead, 51. I read you loud and clear.## replied Early. Johnny nodded at Roy to tell him that their broadcast was being received in spite of them being on the busy coastline. "Rampart, we've a conscious male in his early thirties. Victim of a close quarters pipe bomb. A second victim is a Code F from the same range due to ejecta. There are signs of primary and secondary blast injury. Outwardly, multiple superficial and penetrating wounds are evident about the arms and legs only. He is wearing protective Kevlar ballistics gear that was effective over all vital areas. We are controlling an active left upper thigh arterial hemorrhage with clamps. Stand by for vital signs..." ##Standing by, 51.## said Joe. --------------------------------------------------------------------------------- The silver haired doctor frowned as he wrote down his notes from the rescue call. Thinking a bit, he picked up the black phone on the wall. "Hello, this is Dr. Early. Send down a full trauma team to Emergency. I want an X-ray team, a respiratory specialist, and two surgeons. We've a blast victim coming in with a severe vascular injury. That's right. Just the one... Thanks." and he hung up the receiver. Grabbing a cup of coffee just outside the glass door of the base station, Joe waited for the red light to turn back on with a channel return from Squad 51. ---------------------------------------------------------------------------------- Roy gestured at Lopez. "Keep up that pressure point at the femoral. Watch yourself. There's nail right there." Marco nodded, pressing his gloves down as he leaned in with most of his weight over the area without disturbing the impaled metal. Gage looked up as the gang ran oxygen and a long board over to them from the engine. Johnny shouted. "Guys, go ahead and get him on a high flow! Set it top aperature. He's still breathing okay. But wait on the spine board. We've got to get the rest of this gear off first. Be careful around this." he said, pointing to the still oozing thigh wound that he and Roy had exposed with scissors through pants material. Two used hemostat clamps stuck out of the wound, throbbing with each pulsebeat around the hidden leg artery that they were only partially constricting. "Marco, is that starting to stop yet?" he asked. Lopez coughed, not lifting up his gloved hands over the pressure point in the man's groin. "A clot's forming. But it's still bleeding a bit." Gage leaned over the jagged gash. "Good enough. We don't want to cut off total circulation. Keep at it. If you get tired, switch off with Chet." Kelly smiled as he fussed with the policeman's protective helmet and face shield as he figured out how to pull it off. "Easy, Steve. I got some relief for ya." he said, holding up an oxygen mask. "Just try and slow your breathing down a little. That might be part of why you're feeling so dizzy." he said, seeing the man's eyes spinning around. He had to firmly hold Steve's face in between his knees long enough to finish applying the hissing oxygen supply. "My.. my ears are ringing... badly.." Steve coughed, still gasping. Roy got out his penlight and began a thorough head to toe assessment. "Steve, your eardrums are okay. That vertigo could be after effects of all that noise from the explosion working on you. Do you hurt anywhere else besides your arms and legs?" he said, checking his pupils, mouth, ears and nostrils for occult blood. "My...sinuses. They're burn...burning.." he said, bringing up an abraded hand. As he spoke, a trickle of pink fluid ran out of his nose. DeSoto wiped the fluid away with a 4 X 4, and handed a new one to Chet for him to use. "I know. The explosion's shaken up everything hollow inside of you. That's why I'm checking you out. How's your neck and back? Can you move your feet and hands okay?" he said, checking the red stain on the gauze square for signs of the yellowing edge of cerebral spinal fluid. There were none. Steve cleared his throat, sounding hoarse. "They're fine." he said shakily. "I still feel them." "All right. We're gonna get the rest of this stuff off." DeSoto said, patting the thick armor over Steve's chest. "But don't do any work. Let us do it for you." he told him, nodding to the other officers that it was okay to help get him out of the blast gear. "After that, I gotta cut your uniform off to see where else you've been hurt." "Oh." said Steve. He closed his eyes as he started to shake in reaction. "I'm..I'm so cold." "We'll fix that. How's your pain on a scale of one to ten?" Johnny asked. "F-Four or five." bubbled Steve, grimacing. "Think you need something for it?" Gage said as he placed the steel drum of a stethoscope onto Steve's bare chest. He listened over all areas, tipping his head down to drown out the sounds of the fire hose. "Not ..that bad. Maybe....later." he answered, his face growing blank with shock. "How's Marve?" Then he remembered. "Oh...G*d..." he said, tears falling slowly. Steve blinked, muzzy. "Chief, what are we doing in the parking lot?" The paramedics exchanged looks at the new sign of missing memory. His boss knelt around fine, splattered blood. "Steve, we're all here with ya. So's Mac, Newmy, Scott. We're not going anywhere. And I'm personally going with ya in the chopper." Roy looked up at the detective. "Tell me about this kind of bomb. We need to know the power of the energy it may have released. He may be hurt internally as well." The detective's face became more lined as he watched his man get covered up with a thick wool blanket. "Fireman, this was an L.E. It causes deflagration rather than detonation and the release of energy was relatively slow, we read it went off at under 40 kilopascal or 6 psi. That was a subsonic explosion lacking the overpressurization blast wave that characterizes H.E.s, like dynamite, TNT or C4 gel. It had practically no punch." DeSoto nodded, remembering his days serving in Viet Nam. "So nowhere near the threshold of inflicting deep cardiac or intestinal blast injury?" "Most likely not. It lost a lot of force, just sending out those shrapnel fragments." "Okay, thanks. That info helps." Roy told him. Gage thought of more. "What about the propellant? Will it burn these wounds?" "No. It's gun powder. And it's already cold." replied Cap, who was standing near by, getting their stokes straps ready. "Recognize that smell?" "All I can smell is blood, Cap." Johnny said quietly as he started swabbing off a clear place on Steve's arm for an I.V. start. Roy looked up from taking a blood pressure. "Chet could you set him up on an EKG? Turn it to audible so we can hear it." "Okay." answered Kelly. "A two lead?" "No, twelve. We need the whole picture." said Roy. "Skip the limb leads. They won't stick." Roy picked up the biophone. "Rampart, Squad 51." He accepted Johnny's care notes quickly. ##Go ahead.## said Joe. "Doc, this is what we've got. Blood pressure's 86 over 54. Respirations are still labored at twenty two. Chest is wheezy in all fields. He's exhibiting temporary bouts of amnesia about recent events concerning the incident. On the left, he has a hemotympanum without perforation and bilateral tinnitus. Pupils are equal and reactive. EKG is showing.." he paused while Kelly turned the monitor so he could see it. "...mild bradycardia with that hypotension. Bleeding from the leg is now minimal." Roy reported. "Pulse is 42. Skin cool and wet. He's on O2 being actively treated for shock. Also, he's got some tinged fluid coming from both nostrils that's negative for CNS involvement." Roy clarified. "Sending you a strip, Lead XII." Early read the EKG rhythm swiftly. Then he fingered the talk button. ##After starting two large bore I.V.'s of Ringer's Lactate in both arms, and if he's negative for neck or spinal injuries, raise his head, 51. Assume the patient's wheezing is associated with a blast injury involving pulmonary contusion. Joe's voice became very serious with the next orders, making Roy's eyes widen in surprise. ##Listen carefully. A thoracic PBI produces a unique cardiovascular response, observed nowhere else in medicine, Roy, that might cause an arrest in this victim in the absence of any demonstratable physical injury to the chest.The immediate cardiovascular response to pulmonary blast injury is this decrease in heart rate, stroke volume, and strength. The normal reflexive increase in systemic vascular resistance isn't occurring. That's why his blood pressure's falling inexplicably. Be super-aggressive with those I.V.s. Bag him without an ET if he stops breathing. He should recover a good BP again and regain any consciousness loss, within 15 minutes. Use 1 mg. epinephrine I.V. push only if he goes apneic.## DeSoto looked up quickly. "Two of L.R. Push it. Faster than wide." he told Johnny. "Chet prep an ambu." Gage knelt on the I.V. bag he already had going and passed off the second to an eager policeman. "Squeeze that. Hard. As fast as it'll drip." he told him. Roy was still receiving his orders. ##Look for quaternary injuries, including thermal burns, scattered petechiae, and confluent hemorrhages over all areas above gas containing organs. Suction away hemoptysis as needed and watch for newly developing chest pain. Monitor his neurological status. Primary blast waves cause concussions without a direct blow to the head. That might explain his inability to stay focused on events. Splint his left leg and pelvis and transport by air a.s.a.p. Keep me posted on any further downgrade and we'll manage it together, step by step.## said Joe. ##Contact me every five minutes en route with new vitals.## "10-4, doc. Aggressive fluid and respiratory support. Load and go. Squad 51, out." As Roy hung up the phone, Steve's eyes fluttered shut. "Johnny..." DeSoto warned. "Steve?" asked the detective in alarm. "Guys...!" he pointed urgently. Gage pulled the blanket down and set both hands on the wounded police officer's stomach. "He's breathing. But it's shallow. Chet, help him a little on the ins. Don't overdo it. He's developed lung bruising." he said as he re-covered their patient. "Pulse's still slowing." Kelly said, taking a quick carotid to make sure it was still being felt despite the visual and audio on the monitor. Roy glanced at him. "It's gonna happen. Keep a look out for PEA on the quick view. If he slips into it and loses that beat, yell. Do you remember how that arrythmia presents before it takes effect?" Kelly nodded, keeping up his slow, steady assistance bagging on the unconscious man. "Yeah, you showed me several different kinds on paper strips last month." "I did? Okay." Roy rubbed his sweaty forehead in hurried concentration. "That was smart thinking." Roy hurried as he began to pack up their gear. "Cap, Mike. Carry him head end higher once we get him in the stokes. We'll splint that bad leg once we're in the air." "Want an O.P. in?" Kelly asked them, reaching a couple of fingers into his turnout jacket for the pack of oral airways he always kept there. "No, the doc says he's waking up in a few. Says this is just a temporary reaction." DeSoto told him. He regarded their patient with a close eye. "He does seem to be managing well enough with just that head tilt. How does he feel?" "Easy in-s. No problems." Chet said, as he watched the man's chest rises along with the placement of his fingers over the mask of the bag valve resuscitator. He repositioned them lightly to stop a sudden face leak. "Kelly.." DeSoto said, dissatisfied. "..do you want the detective to help you? Looks like you might need two people there." "All right, I can use him." agreed Kelly quickly. "He's shivering a bit." "I'm here. Right here." said the worried chief. "Just like CPR class?" he said, taking over Chet's finger-cupped mask hold. "Yep." said Chet. "Use two fingers to lift up his jaw as you do that. It works better. Grab the mask like you guys hold a shot gun, in a double grip." he shared, as he began to use both hands to squeeze the breathing bag. "See?" "Yeah.. yeah.." said the cop when he felt an easier flow of oxygen begin to move through Steve's wider opened windpipe. "I got it." Cap spoke, telling the rest of the worried, still armored policemen to step back as he and the rest of the gang lifted Steve off the wet pier planks and into the wire basket. "Thanks, fellas, we've got him from here. He's going to Rampart Emergency. Marco, replace yourself with a couple of sandbags, then help us carry him to the pier's entryway. Is he and the gear all in and strapped down? Okay, guys, let's move him out!" ----------------------------------------------------------------------------------------- Joe Early abandoned the bomb squad man into the hands of his surgeons. He soon returned to the front desk by Dixie's stool. He smiled when he saw Roy and Johnny reassembling their spent resuscitation tank with fresh parts as they kneeled nearby. They were also recoiling the wires on the EKG monitor back into reassessible potability inside of its defibrillator case. "Hey, Roy, Johnny, Chet. Nice job on our patient." "He's gonna make it?" Gage asked in an incredulous tone. "You doubt your acting physician's direct prognosis?" he chuckled. "Of course he's gonna make it. That explosion was an L.E. Those only kill with the debris it manages to fling out." "That's a relief. It was pretty touch and go for a while there once we were airborne." said DeSoto. "For a few seconds, Chet, Johnny and I thought we had actually lost his pulse." "That was just his further slowing bradycardia. Bound to skip a beat or two at the height of its effect. He didn't lose color at all, did he?" Early challenged in good humor. "No. That's what finally clued us off that he wasn't shockable." Roy smiled. "That and the heartbeat Johnny heard apically." "Glad you weren't fooled into attempting compressions. Our man's got enough healing to do without adding cracked ribs to the mix." "So what's the next step for him? Past that surgery to repatch his leg artery?" Johnny wondered. Joe shrugged. "A couple of chest x-rays for sure, eventually. Blast lung produces a characteristic “butterfly” pattern on films. His next risks are systemic air embolism, and free radical–associated injuries such as thrombosis, lipoxygenation, and disseminated intravascular coagulation." "Fat balls, air bubbles and clots in his tissues and circulatory system?" Gage wondered. Then he gave out a long sigh of sympathy. "Yes. Those are secondary complications. He may even develop ARDS as a result of his direct lung injury, which has turned out to be something called acute gas embolism, a form of pulmonary barotrauma. The air and fat emboli that have broken free into his lungs, might later occlude blood vessels in the brain or spinal cord." "Sounds nasty." said Kelly. "It's like he got the bends from a firecracker." "Apt analogy. Things can get bad. But I have every confidence that he won't reach a stroke or paralysis endstage. We got his pressure back up fast enough and you guys did an absolutely terrific job by not jostling him unnecessarily during flight." Early told them, pleased. Roy accepted the compliment gracefully, as did the others. But he was still worried. "What about his intestines? I didn't hear active peristalsis." Joe held up his hand to reassure him. "Abdominal injuries from explosions may be occult, showing up only days later. Serial examinations are often required. But in his case, that air by the sea was a very poor conductor of blast-wave energy. It was too thick to push very far. In fact, any close quarters pressure changes he might have experienced colon wise had to work through all that tough body armor first. His blood work's coming back good, all things considering. I think they're just in spasm for now, because he's still cold. It won't be long before he reawakens in Recovery under heated blankets, and when he does, they'll most likely follow suit." Gage relaxed. "I really thought he was goner, doc. He's my first bombing victim." "I hope you'll never see another case." said Joe. "They are the most complexly injured patient that any paramedic ever encounters." Roy agreed, regarding his partner with a look of deep thought and a little sorrow. "I hated seeing that outside of a war zone.." he broke off, "Incendiaries are a horrific way to maim and destroy people." Gage set his hand on DeSoto's shoulder, remembering his war vet status only belatedly. He didn't look at Roy's face, offering him a bit of privacy for the emotions that were still twisting on his features. He changed the subject by asking Joe another question. "How's Dr. Morton doing? Is he any better?" Joe looked up from his coffee cup and replied... ------------------------------------------------------------------------------ Photo: Ambu over your face. Photo: Various EKG strips showing pulseless electrical cardiac activity. Photo: A pipe bomb exploding behind a barrier. Photo: A policeman in ballistics gear. Photo: Cap and Stoker looking on, worriedly by the engine. Photo: Gage holding up a piece of shrapnel. Photo: Joe and Roy talking over Dixie's desk. Photo: A Mayfair parked at Rampart. Photo: Roy looking horrified. ************************************************** From : patti keiper Sent : Wednesday, July 11, 2007 11:01 PM Subject : A Little Sugar and Cream Never Hurt Anybody.. "Well, I don't know the latest, since I've been filling in for Kel and Dixie down here, all night. But I can tell you that--" "He's awake, on soft foods, wiggling all of his fingers and toes, and asking for visitors.." said a happy, husky voice approaching from down the hall. "Dixie!" said Roy, Chet, Johnny and Joe joyfully. Gage gave her a hug. "Boy, am I relieved. So he's over his crisis?" "Yep." she said, accepting the embrace. "Any further complications?" asked Roy. "Nope." she replied, returning Roy's smile. "Who's Dr. Morton?" asked Chet. Gage burst out laughing. "Chet, you mean to tell me that you can't remember the man who got you started on the great crash diet craze?" He let Dixie go, and offered her a cup of coffee. Chet shook his head. Johnny tried again. "Remember when you tried to starve our whole shift half to death? It was about the same week Cap almost got electrocuted on that wire." Chet shook his head a second time. Gage got real bugged, thinking Chet was up to some funny business. "Are you kidding me about this?" he asked suspiciously. Kelly shook his head once more, exactly like the first two. "Okay, I believe ya." said Johnny, putting both hands into his pockets. Roy sighed, rubbing his chin, still studying Chet who saundered over to the drinking fountain to wet his whistle. "All those figs he ate back then, must have wiped out his memory or something, eh, Johnny?" "No, maybe WE did, after we glommed onto him for inflicting that diet of his on us." Johnny scoffed, good naturedly. But then he snapped his fingers, getting an idea. "Say, Roy? Let's see if he remembers Mike after his memory's jogged a little, shall we? Dix? Is Morton still in the same room?" "No, he's been moved to the general floor and out of ICU. He's in 309 East." McCall replied. They started off for the elevators. She stopped them. "Wait a minute. You guys don't have a 'get well fast' card, gift, or anything to offer Morton yet. Why go right now? He'll be better rested tomorrow." she reasoned. Gage leaned backwards into Dixie's ear. "Yeah, but tomorrow Chet won't be here to see him. Get my point?" "No." she answered truthfully, looking blank. Johnny humored her, indicating to Chet and Roy that he was heading for the souvenir shop. "We'll think of something. You're welcome to come along with us." "Nope. For today, I'm his nurses' supervisor. He doesn't get to see me again unless he's dying a second time and I'm pushing in his crash cart." she quipped. "Once was bad enough." Roy scratched his head. "This is a little unrelated but...How come doctors can treat other doctors, and nurses other doctors, but paramedics can't treat their own family members?" Dixie made a face. "Personal involvement?" Joe laughed. "Ah, I believe the key word is intimate personal involvement." McCall chuckled. "Well, that doesn't wash. Kel and I were involved when I broke my ankle six years ago." Gage grinned. "Yeah, but he wasn't the one who reset your bone. Dr. Rivers did that. Kel only came in there to gloat." Dixie frowned. "Don't remind me. I hated every minute of being a patient in my own department." Roy looked at her. "Think of it from Dr. Morton's perspective. He's got it worse. He's going to be a patient in his own hospital for at least week or more." Dixie grew thoughtful. "Hmm. Maybe I can rub that in a little." Joe smacked her arm. "Don't you dare. He's still a sick man." McCall compromised. "Okay. I won't. I'll wait until he's filling out the discharge papers that only I'll be bringing him." Roy smirked. "You're evil." "No, just playful." she corrected evenly. "Gotta make up for all the gruffness he's dished out on my nurses today one way or another. They aren't standing up to him one iota. I've been watching." Joe sighed. "That's because he's a doctor." he teased in a whisper. Dixie held up a finger. "No, it's because he's Dr. Morton. There's a difference." she explained carefully. " 'Bedside Brusk', that's what they call his personality." "Can't say that's not true.." Joe admitted honestly. "But he's still a h*ll of a good resident and I'm glad I work with him." "Uh, huh. You work WITH him. Not under him." McCall clarified. "He's a whole different man if you're living in our shoes." she said about herself and the other nurses on her staff. Joe smiled, realizing he was treading in increasingly hot water. He glanced at Roy and Johnny. "Keep it short. He's still tired most likely." Gage started giggling. "We will. See you later. Come on, Chet. Start breaking out your wallet. I wanna pool our money together to buy Mike a gift. Ah, ah, ah.. Before you open your mouth, don't worry.." he added, fending off Chet's not yet formed complaint. "We'll both pay you back before the shift's over, okay?" "Okay, but I still don't know this Morton guy." Kelly said. "Oh, you will." said Johnny. "Boy, will you!" he laughed. Roy agreed. "In a couple of seconds." --------------------------------------------------------------------------------------------------- A quiet knock at the door alerted Dr. Morton to open his eyes. He tried to clear his throat when he remembered yet again that the drain tube was still threading out of his back around the sutures. He decided not to move again. But the well aimed pillow had silenced the EKG monitor that had been bleeping over his bed. Mike had been sweaty and panting after that little goal was accomplished, but he was VERY proud of himself for the silence that he had won. Until now. He began to grumble but then stopped himself when the knock repeated even softer than before. "Come in?" he replied reflexively, finally recognizing that the raps were friendly and not at all medically efficient like those of the nurses caring for him. "Dr. Morton?" asked Roy through the crack in the door. "Are you awake?" Mike sat up in his bed, grimacing a little. "Yeah. Come in. All three of you." he gasped around his nasal cannula. "Dr. Morton, how are you feeling?" Gage began when they had entered. "Fellas, please, call me Mike." he smiled. "I'm a patient now." "Okay." Johnny smiled warmly, still being quiet. It didn't work very well when a brown paper bag behind his bag rustled loudly from where he had it hidden. "Is that Chester Kelly?" Morton trickled, squinting a little. "Yeah. Uh,.. hi." said Kelly, truly acting like he didn't know Morton. "Don't you remember me? I turned you into a real bonafide health nut by accident." Mike said to him. "Really? Well, isn't that kind of like what a doctor is supposed to do for his patient?" Chet asked, guessing what their relationship had been. Johnny smacked Kelly on the arm. "Chet, you weren't his patient. He was your advisor, at the station. You two discussed nothing but food for an entire hour in the bunkroom according to Cap." "Doesn't ring a bell. But I'm really glad to meet you now. Man, the other day, I thought you were a goner." he said, leaning over the bed as he held out his hand. Morton grinned, taking the offered handshake into his own."Sorry to disappoint you then, Chester B. Guess these two paramedic boys are just too d*mned efficient to play the sudden death game very often, huh?" Chet confided in him. "Yeah, they don't like getting halos on their patients. So,...You got all your toes and fingers back." "I sure did. No paralysis whatsoever. See?" he said wiggling them under the blankets. "But seriously, fellas. It's my turn to say that I'm grateful I'm still alive." he told them. "Roy, Johnny. I heard what you guys did for me this morning when I stopped breathing." Gage shrugged, crossing his arms respectfully. "We didn't do much. We just... took over for the machine for a while until your seizure was knocked out." "I would have died." Mike said significantly. "Sure the code blue team would have eventually brought me around. But not easily if my heart had gone out as well. And all that CPR you prevented could have redamaged my spinal fracture site. Then where would I be?" "I don't know." said Roy, not willing to brag, even as he smiled. "I probably wouldn't be a doctor any more. All that motion would have severed my spinal cord, Kel said. He just saw my X-rays a couple of minutes ago." Mike shared. "So, please, accept my thanks... from the bottom of my heart. Literally." Roy and Johnny were struck speechless, very touched. "No problem, Mike." Chet said for the both of them. Then he reached back and snagged the bag Johnny still held out of sight. "Hey, did you see what we brought ya?" Kelly asked. "You're not restricted to just clears are you?" "Nah, I'm up to soft food already." "Good, 'cause you're gonna love what we brought ya." Chet said, dumping out the contents onto Mike's bed covers. Mike's lit up eyes, then fell into a look of confusion when he saw what his gift items were. "Three eggs, a can of evaporated milk, a salt shaker, a jar of strawberry preserves and a half pound of sugar?" "Oh, and don't forget these." Johnny said eagerly, handing over a wooden spoon and a porcelain mixing bowl that Roy had been hiding. "What are these, boys? Are you sure you brought the right bag?" he laughed. "Sure we did." said Johnny eagerly. "Haven't you ever heard of homemade ice cream before?" Morton rubbed a scab on his nose left over from the sea chafing he had suffered. "Yeah. But I don't see any ice here, do you?" For a few seconds, Roy, Johnny and Chet's faces fell into ones of deep dismay but then, just as quick they dropped all pretense, letting Dr. Morton off the hook. "Got ya. Of course we didn't forget the chilly stuff. How could we? That wouldn't have been very smart." Morton looked at them expectantly, lacing his fingers together. "So,..where it is?" Gage snapped his fingers. "Gimme your pillow case." he ordered, grinning. "I beg your pardon?" Morton sputtered. "Your pillowcase." Roy repeated, looking highly amused. Shrugging, Mike lifted up his head and started to grab the soft bundle under his head. "No, not that one. Hand us the one you're not using." Chet said with duh, written all over his voice. Mike sighed and did so. "This is crazy, absolutely nuts." "Not really. It's called..." said Chet expansively. "Science.." he finished mysteriously. He went on in a voice sounding like an absent minded professor. "As liquid evaporates, it gets cold. This effect, familiar to anyone who has been wet, happens because it takes energy to turn a liquid into a gas, and that energy comes from heat drawn out of the liquid. How that interaction works is one of the most complicated subjects in science, but what’s important, is that it can be used to make.... homemade ice cream." "I don't get it." Morton gestured, crossing his arms together around his shoulder cast as best as he could, in puzzlement. "Oh, you will. You will." said Gage. "Shh, I think Chet's on a roll here." he whispered, sotto voce'. Chet went on as if their little exchange had never taken place. "Now, you can’t just let cream evaporate and expect to get ice cream. No... Water in the open air won’t freeze from evaporation alone. But evaporating pressurized liquid carbon dioxide, draws so much energy out of it, that about a third ends up frozen solid." he concluded. "That’s dry ice." added Roy, waggling his eyebrows like Groucho Marx. Morton started to giggle around his pain meds in spite of himself. "Just where do you get a tank of liquid CO2? From fire equipment pros, of course. Like any of us firemen." Kelly droned on, completely oblivious to the fact that he had Morton in stitches, a kind you couldn't snip when all the healing was done. Roy and Johnny got into the presentation. Jogging quickly over to the other side of the room, they snatched open the fire extinguisher case with a flourish. Morton's eyes got real big. "No.. You're not going to use that to--" "Shhh. Do you want your EKG to speed up any faster? Having a nurse fly in here right now to check up on that'll only spoil our party." Johnny insisted, pushing Mike back down onto the bed. Chet opened his eyes. They were twinkling. "Discharge a 10-pound CO2 fire extinguisher full blast into a pillowcase for about 10 seconds, and you’ll have several pounds of finely powdered dry ice." He demonstrated that step most enthusiastically, until he had some. "Don’t play with it though. Dry ice can give you frostbite in a few seconds." added Roy, still doing his Marx impersonation with an invisible cigar. Morton was turning red, fighting himself to keep laughter inside so he wouldn't trigger his cardiac monitor alarms. Gage took over. "Then it’s a simple matter of pouring it into a bowl of ice-cream ingredients and stirring until frozen." He did so, splashing everything together into the bowl that he began whipping up. "Add the dry ice slowly to avoid the hard-as-rock syndrome..." said Chet, doing so. "And wah la.. Instant strawberry ice cream." said Roy, in his normal voice at last. "Dig in.." they all said at the same time. Morton chortled, and accepted the plastic spoon that Johnny dug out of his untouched green jello. "So is it edible?" he asked, making a face. Gage shrugged. "Why not?" he returned, leaning on the frost discharged extinguisher with his chin. "These were originally invented to be used in restaurant kitchens. CO2 fire extinguishers are still filled only with food-grade CO2." Mike wiped the tears out of his eyes and tasted a small sliver of the stuff. "Interesting." he said as the pink creamy lump melted on his tongue. "So tell me, carbon dioxide is what makes soda fizz, right?" "Right." they replied. He tipped his ace. "This ice cream actually came out carbonated." "What?!" the guys exclaimed. They just had to dig their fingers into the bowl to taste it themselves. "Not bad." said Morton, with his mouth full. "But don’t plan on seeing CO2 Crunch in the ice-cream case any time soon. It makes your teeth pop." he concluded. "And I wouldn't recommend eating any of the lumps either." "Why not?" Gage wanted to know. "Because they're pure dry ice. Get me a glass of water. I think I froze my spoon to the roof of my mouth. Ow.." "What?!" Johnny sputtered. "Easy, doc. Don't close your mouth!" Roy panicked. "Shall I call for another doctor? Oh, no! Man chokes to death in his own hospital r--" Kelly quailed. "Quiet, Chet, and go get us some hot water. That'll work better." snapped Johnny, as he held Mike's jaws open so he could continue to breathe. "Guyth?...Guyths? Really, I'm thine. Juth gith me a bith, and we'll keet on eating. I'm acthually quite hungee." Mike mouthed around the spoon. "You are?" Johnny paused, his fingers still inside Morton's mouth. "Yeth." said Mike. He exhaled a big breath and his tongue released the stick of the spoon. "Ahhh. It's come off. Skip that lavage, Chet. I'm free!" said Morton aloud. "Grab yourselves a couple of those plastic puke basins, boys, and I'll divee this delicious glop up, fair and square." he beamed, finally forgetting his pain for the first time since his near fatal plane crash accident. Behind him, Chet smiled. ::Goal accomplished. Man! Doc, patients don't need morphine all the time.:: he thought. ::Don't they always say that laughter's the best medicine of all? I rest my case and point.:: FIN Episode Forty Six, The Long Hours Emergency Theater Live ------------------------------------------------------------ Photo: Joe and Dixie smirking at each other. Photo: Johnny and Roy regarding Chet with weird looks. Photo: Chet at Rampart in his turnout. Photo: Morton with incredulous doubt on his face. Photo: A fire extinguisher going off inside a pillow case. Photo: A pillow case full of dry ice being poured into a bowl. Photo: Pink ice cream made from dry ice. Photo: Roy and Johnny totally breaking up into humor at Rampart. ************************************************** Emergency Theater Live® =+=+=+=+=+=+=+=+=+=+=+=+ ETL Hosts : Patti Keiper and Erin James in the United States **Theaterhost@voyagerliveaction.com Emergency Theater Live® "Offstory" Email Address For Midi Music Requests and General Inquiries http://www.voyagerliveaction.com/emergency.html Emergency Theater Live® Homepage http://groups.yahoo.com/group/emergencytheaterlive Writer's Pre-Production Distribution Site http://www.myspace.com/emergencyfans Emergency Theater Live®/Emergency Fans Unite at MySpace ETL's Emergency Community Forum http://emergency.tv-series.com/ ____________________________________ Mark VII Productions, NBC, and Universal owns all of Emergency!© and its Characters. 2009©. All rights reserved. ========================= ***NOTE: All author writings submitted to the theater will be set free onto the web to reach as many readers as we can manage to find. Contributing to any ETL episode means that Voyagerliveaction.com has permission to publish your work in the manner presented here on this website and on text versions of the stories on other sites. All web audience writers or volunteer consultants and their corresponding emails will be duly recorded and left in place within each show's music and imaged airing episode, pointing out that fan or professional EMS personnel's creative contribution. Theater Host- Emergency Theater Live!®..