Chapter 49: Within the Five Percent

15 July 2000 – Wellington Circle, Medford, Massachusetts

{c}This chapter includes unseen violence against preschool-aged children. The result is visible in the chapter, not the action.

Reader discretion is advised.

“McGregor’s lucky that ceiling didn’t cave in while he was sleeping in his bunk three nights ago,” Shawna commented while they waited for their coffee order.

She and Jeff were posting at Wellington Circle, a major intersection of state routes in Medford. Wellington was a favorite place for Brophy to have their ambulances cover multiple cities, or ‘post,’ since it was convenient to three other municipal contracts.

Paramedic Thirty-one was currently covering four cities: Medford, Melrose, Malden, and Brophy’s newest contract, Everett. The crews didn’t mind posting at Wellington Circle, because it boasted a twenty-four hour coffee shop with clean bathrooms.

“I know,” Jeff replied. “Being covered in drop-ceiling tiles and rainwater is not the way to wake up. We needed the rain but not that frog-strangler we got that night.”

”’Frog-strangler?’”

“Um, gully-washer?”

“Oh, okay, I’ve heard that term.”

“Sorry, the locals near Benning and Bragg used to use that, so I must have picked it up when I was in the Army. On the bright side now we know what was causing your runny noses for the past year.”

A violent rainstorm on the Tuesday overnight shift dropped nearly three inches of rain on Medford and the other cities just north of Boston. The slow leak in Medford Station Five’s roof hadn’t held up to the increased water pressure; it allowed the rain to enter and soaked the ceiling of the Brophy EMS quarters built in the apparatus bay, causing its collapse. The previous slow leak hadn’t been enough to cause a collapse, but it did allow black mold to grow inside the walls of the EMS room.

“Well, they say it’ll only take a week or so to build us a new room,” Shawna commented. “It was cool of the guys at Station Five to let our overnight crews crash in the recliners until it’s complete.”

“The extra hour Brophy’s paying us to be based out of Malden and drive over to Medford for now is cool, too.”

The woman behind the counter handed them their ice coffees with her usual bright smile. “Thanks, Jasmine,” Jeff said, waving off Shawna’s offered payment. “I got this one,” he told his partner while handing Jasmine a ten dollar bill. Jeff dropped the coins and the dollar bill from the change in the tip cup while pocketing the five.

“Thanks, guys!” Jasmine said in response to the tip. The young mother’s smile always brightened people’s days when they came in.

“You have a good day, Jasmine,” Jeff smiled back.

Shawna and Jeff walked back to Thirty-one and unlocked it. Rolling down the front doors’ windows they reclined in their respective seats and propped their feet on the window frames.

“Can you imagine working in an office?” Shawna asked from the driver’s seat.

“Nope,” Jeff replied.

It is said that public safety work is ninety-five percent boredom mixed with five percent sheer terror; Jeff was content to be bored today. His eyes were closed as he felt the warmth of the sun on his face. Eighty-three degrees, crystal-clear blue skies, a light breeze and the calls all going to other units so far today. Perfect.

We found a parking spot under a tree, too, Jeff thought.

All of that should have been a clue that their day was about to go to shit.

“Operations to Paramedic Thirty-one?”

Until they moved back into Station Five, Brophy’s dispatch center would assign the calls to Medford A-One. Shawna picked up the microphone.

“Thirty-one, Wellington Circle,” she answered, giving their current location.

“Thirty-one, in Medford, twenty-eight hundred Mystic Valley Parkway, apartment two-fifteen. Two-eight-zero-zero Mystic Valley Parkway, apartment two-one-five, Medford, for the pediatric altered mental status.”

“At least we’re close...” Jeff muttered while he pulled his legs into the truck and closed his door.

“Thirty-one has twenty-eight hundred Mystic Valley Parkway, apartment two-fifteen, Medford,” Shawna acknowledged.

As her door closed she started the truck, cranking the a/c as the windows rolled up. Jeff hit the emergency master switch, activating the lights while he signed on with Medford Fire Alarm for the response. Three minutes later, Paramedic Thirty-one rocked as it entered the Mystic River Apartments complex.

“Thirty-one, we’re going out,” Shawna said to dispatch when they pulled up to the building.

“Thirty-One. Apartment two-one-five.”

Jeff pulled on his gloves while they parked along the curb. He grabbed the portable radio and exited the cab of the truck; he switched it on and turned to the Medford Fire Alarm frequency. He piled their equipment onto the man-and-a-half stretcher before Shawna took it out of the truck.

They made their way to the door of the building, wedging the door open for the fire department personnel responding behind them. The elevator was working today and they only waited two minutes for it to arrive. They had to wait another minute for the occupants to exit.

“What’s going on?” an exiting resident asked while they steered the stretcher into the small space.

“Ambulance call,” Jeff replied in a disinterested voice.

“I know that,” the man answered. “What’s the emergency?”

“Sorry, Sir. We can’t tell you,” Jeff said as they finished fitting the stretcher in the elevator.

“Huh?” the man asked, confused. “Hey, I live here!” he declared. “I have a right to know!”

“No, Sir, actually you don’t.” Jeff replied. “Your neighbors all have a right to privacy.” He pushed the ‘door close’ button over and over.

“What? So you’re not going to tell me?”

“Exactly,” Jeff stated while the doors closed.

“What a Richard...” Shawna muttered, shaking her head as the elevator rose.

On the second floor they maneuvered the stretcher out of the elevator and down the hall to apartment two-fifteen; they shared a chuckle about the man in the lobby. A man opened the door to the apartment for them and they entered, still shaking their heads. They stopped laughing when they crossed into the apartment and took in the scene in the front room.

They didn’t have a pediatric patient, they had two. Both children were young girls under five years-old, both were unconscious, both had visible marks on their faces. Shawna and Jeff moved, now all business. Kneeling next to the older girl, Jeff keyed the microphone of the portable radio.

“A-One to Fire Alarm? Who’s coming to twenty-eight hundred Mystic Valley, apartment two-fifteen?”

“A-One, this is Engine Five.”

Jeff recognized the voice from the radio as Captain Nick DeCosta of Engine Five, someone he’d known since he started working in Medford.

Thank God, he thought.

“Engine Five, expedite. We have two pediatric patients, both are unconscious.”

“Engine Five, roger.”

In reality a fifteen- to twenty-ton fire engine is not going to start driving faster when you tell them to “step it up.” They’re already driving as fast as they safely can; there are too many reasons why they can’t just floor the accelerator. What the crew will do is move quicker than normal once they arrive on-scene.

“What happened?” Jeff asked the man who’d let them in.

“I dunno,” he replied. “They fell while they were playing a little while ago; I think they hit their heads. They were acting funny after that, tired, so I called 9-1-1. Then they both collapsed just before you got here. I called their mother.”

People in EMS can be suspicious people thanks to the nature of their job. They are trained to look for problems, and to keep looking if they don’t find any; they can also tell when they are being given a false story. This was one such time. Jeff kept his suspicions to himself; glancing at Shawna, she gave him a look that told him she was thinking along the same lines.

Jeff checked his patient’s pulse - or he tried to. As soon as he touched the girl, her back arched, her arms extended, her wrists curled outward, and her toes pointed; this was a reaction called ‘decerebrate posturing.’

Oh, shit.

Posturing is a sign of a brain injury; it indicates that the brain is trying to squeeze itself through the hole at the bottom of the skull as it swells. When a person postures the way Jeff’s patient was, it’s a late sign of injury. Outcomes in cases with those signs are often not good. Finding the pulse in her wrist, Jeff noted it was slow, thready. Her breathing was becoming irregular. When he checked, her pupils were unequal and sluggish.

Ohshitohshitohshit.

“Cuff!” he called to Shawna and she tossed the pediatric blood pressure cuff to him; his patient’s pressure was elevated. They needed to go. NOW.

“Level One, decerebrate posturing. What do you have?” he asked his partner.

“Level Two, stable,” Shawna answered.

“Does yours need O2?”

“Sat’s fine and her breathing is regular,” Shawna answered, indicating that her patient’s oxygen level was within normal limits. “I can wait till we’re in the truck. Take it.”

Hearing her answer, Jeff grabbed the oxygen bag. With practiced moves he placed his patient on one hundred percent oxygen via face mask. Jeff spoke to the man again.

“You the dad?”

“No, I’m Jasmine’s boyfriend. Their mom’s boyfriend.”

Jasmine? Please no!

“Where’s she?”

“At work. The coffee shop in Wellington Circle.”

Shit! These are Jasmine’s girls! No, no, NO!

“Do you know their names, ages, dates of birth? Stuff like that?”

“Some of it.”

“Write down what you know, please?”

Jeff turned back to his patient and performed a head-to-toe exam, looking for more injuries. He cataloged the injuries he found: tenderness of the scalp, facial fractures and bruising, marks on her face and chest, broken ribs, rigid abdomen. On the outside he was calm and controlled; but, deep inside of him, a part of him seethed.

The man handed him a piece of paper with the information Jeff asked for. Though his patient was his focus, Jeff noted something out of the norm on the hands of the man: there were scrapes on the man’s knuckles; the man also wore a ring on one hand which matched many marks on his patient’s face and torso.

Goddammit!

Jeff nodded as he took the paper and keyed his radio mic again.

“A-One to Engine Five?”

“Go, A-One. We’re about three out.”

“Cap, on arrival we’ll need the pedi board, the KED, and our collar bag. Call Blue and invite him to the party. One-and-one, minimum. The folks from the back hall here and at the General, too. We’ll need a driver.”

“On it, A-One. Less than two.”

Jeff didn’t acknowledge; Nick would know what his message meant and that he’d be busy. Jeff found a vein on the inside of his patient’s right arm that he could thread an IV catheter into. Once that IV was secure, he moved to her left side and repeated the procedure. Jeff heard a welcome call over the radio while starting the second IV.

“Engine Five’s arriving, Fire Alarm.”

“What do you need, Jeff?” Nick DeCosta asked, stepping into the scene two minutes later followed by his crew.

“Pedi board and collar. Give the KED and a collar to Shawna. Load the bags onto our stretcher and take everything to the ambulance? We’ll carry the girls down the stairs; we’re out of here as soon as they’re immobilized and I don’t want to wait for an elevator. Who’s gonna be driving our truck?”

“Stan.”

Stan Williams was Nick’s most experienced firefighter; Jeff nodded in acknowledgment. Both members of Paramedic Thirty-one finished readying their respective patients for transport. A sergeant and two officers from the Medford Police Department appeared in the doorway; ‘Blue’ had arrived at the party. Jeff felt the boyfriend, who was standing behind him and who’d been told multiple times to step back, stiffen when he saw law enforcement.

“Um, maybe you should wait for Jasmine to get back before you leave?” he stammered. Jeff and Shawna ignored him, as did everyone else in the room. “Hey!” the man exclaimed, trying to get Jeff’s attention. “Hey, I’m talking to you!”

He got that attention, and a lot more, when he grabbed Jeff’s shoulder.

People routinely exposed to emergency situations often assume a calm, detached, dispassionate demeanor to shield themselves from the horrors of those moments while in the middle of them. Everyone, however, has their breaking point.

When the man touched him, the locked door inside Jeff containing his rage gave way; with a growl he drove his elbow back into the boyfriend’s genitals. The man fell into the wall behind them retching and gasping for breath.

“Nick, bags?” Jeff asked while slinging the oxygen bag across his back.

“Already outside,” the captain replied. Scooping up his patient, Jeff moved towards the door. Jeff looked at the MPD sergeant while pausing in the doorway.

“What?” the sergeant asked in response. “What are you looking at me for? I saw you defend yourself against a violent suspect, one who assaulted you in the course of your duties as an EMT.” Jeff nodded at the man.

“Have the detectives take pictures of his hands and meet us at Mass General; they’ll need to compare those pictures to some marks on the girls.” Jeff stepped out of the apartment and turned down the hall; Shawna was right behind him. One of the officers followed as well, to open doors if needed.

“Right!” the sergeant called after them.

Jeff and Shawna moved for the stairs; they were careful not to trip with the precious cargo in their arms as they sped down them. He and Shawna reached the ground floor and crossed the building’s lobby. The man from the elevator made a reappearance.

“Hey! I want to talk to you!”

“Sir, not now,” Jeff said, his voice tight, clipped.

“Yes, dammit, right now!” the man stated, stepping between Jeff and the door.

“Sir, move out of the way!” The MPD officer started to move towards the front of the small group.

“Not until I talk to you!”

Jeff growled, dropped his free shoulder and sent the man flying with a solid body check.

“Keep going!” the officer called as he stopped next to the man and took out his handcuffs.

Jeff crashed into the bar to open the door, never slowing while leaving the building. At the ambulance, Engine Five’s crew helped secure the sisters - one on the stretcher, one on the bench seat in the back of the truck. Jeff checked that all of their equipment was accounted for.

“Thanks, guys!” he called to the firefighters when they exited. They waved as Jeff pulled the back doors of the ambulance closed. “Stan?”

“Here, Jeff!” Stan Williams called from the front seat.

“We’re ready! Mass General!”

“Got it!” Stan notified Brophy and Fire Alarm of their destination while he pulled away from the curb.

Jeff’s patient was getting worse. Her breathing pattern was slower, more irregular, her pupils more unequal and her heart rate slower than when in the apartment. He opened the pediatrics bag and measured his patient with a color-coded tape. He prepared the appropriate laryngoscope and endotracheal tube from the indicated colored pouch to secure his patient’s airway.

His left hand manipulated the ‘scope, lifting his patient’s tongue while his right hand slipped the uncuffed tube in. He watched as the tube passed over the tongue and through the vocal cords. A device detected the presence of exhaled carbon dioxide from the girl’s lungs and turned from purple to yellow.

While Shawna squeezed air into the girl’s lungs Jeff used his stethoscope to listen to her chest. Hearing all the right things, and none of the wrong things, Jeff wrapped tape around the tube, behind the patient’s neck, and then around the tube from the other side; this was to secure the tube and prevent it from coming loose.

“How’s yours?” Jeff asked Shawna.

“More stable than yours: unconscious and a bruise to the cheek,” she replied as she slipped an oxygen mask onto the girl’s face. “She won’t need a tube from us.” Jeff pulled the paper with the girls’ names from his pocket.

Hang on, Liliana... Jeff picked up the microphone next to him.

“Boston CMED, Boston CMED, Brophy Paramedic Thirty-one calls from the Medford/Somerville line.”

“Brophy P-Thirty-one?”

“CMED, Thirty-one. Two patients, one Priority One and one Priority Two, Mass General. Trauma Alerts on both, please.” Jeff switched to the channel specified when CMED responded; he heard the warbling tone requesting medical control from the receiving hospital.

“Uh, this is Mass General Hospital,” came the response. The doctor at the other end didn’t give their last name; Jeff didn’t recognize the voice, either. This wasn’t starting well.

“Mass General, Brophy Paramedic Thirty-one, Paramedic Knox calling. Please identify yourself, Doctor.”

“Uh, this is, uh, Dr. Friedreichson.” A new, uncertain voice and an unfamiliar name at a teaching hospital in the month of July meant one thing: a new intern. Interns weren’t supposed to be anywhere near the radio yet.