really solved. That was not something pleasing to the sergeant. He looked at the paramedics. 'How is he, Mike?'
'Damned near bled out, Bert. Definite shotgun,' the man answered, affixing the cervical collar. 'A bunch of pellets in the neck, some near the spine. I don't like this at all.'
'Where you taking him?' the police sergeant asked. 'University's full up,' the junior paramedic advised. 'Bus accident on the Beltway. We have to take him to Hopkins.'
'That's an extra ten minutes.' Mike swore. 'You drive, Phil, tell them we have a major trauma and we need a neurosurgeon standing by.'
'You got it.' Both men lifted him onto the gurney. The body reacted to the movement, and the two police officers - three more radio cars had just arrived - helped hold him in place while the firefighters applied restraints.
'You're a real sick puppy, my friend, but we'll have you in the hospital real quick now,' Phil told the body, which might or might not still be alive enough to hear the words. 'Time to roll, Mike.'
They loaded the body in the back of the ambulance. Mike Eaton, the senior paramedic, was already setting up an IV bottle of blood-expanders. Getting the intravenous line was difficult with the man face down, but he managed it just as the ambulance started moving. The sixteen-minute trip to Johns Hopkins Hospital was occupied with taking vital signs - the blood pressure was perilously low - and doing some preliminary paperwork.
Who are you? Eaton asked silently. Good physical shape, he noted, twenty-six or -seven. Odd for a probable drug user. They guy would have looked pretty tough standing up, but not now. Now he was more like a large, sleeping child, mouth open, drawing oxygen from the clear plastic mask, breathing shallowly and too slowly for Baton's comfort.
'Speed it up,' he called to the driver, Phil Marconi.
'Roads are pretty wet, Mike, doing my best.'
'Come on, Phil, you wops are supposed to drive crazy!'
'But we don't drink like you guys,' came the laughing reply. 'I just called ahead, they got a neck-cutter standing by. Quiet night at Hopkins, they're all ready for us.'
'Good,' Eaton responded quietly. He looked at his shooting victim. It often got lonely and a little spooky in the back of an ambulance, and that made him glad for the otherwise nerve-grating wail of the electronic siren. Blood dripped off the gurney down to the floor of the vehicle; the drops traveled around on the metal floor, as though they had a life entirely of their own. It was something you never got used to.
'Two minutes,' Marconi said over his shoulder. Eaton moved to the back of the compartment, ready to open the door. Presently he felt the ambulance turn, stop, then back up quickly before stopping again. The rear doors were yanked open before Eaton could reach for them.
'Yeow!' the ER resident observed. 'Okay, folks, we're taking him into Three.' Two burly orderlies pulled the gurney out while Eaton disconnected the IV bottle from the overhead hook and carried it beside the moving cart.
'Trouble at University?' the resident asked.
'Bus accident,' Marconi reported, arriving at his side.
'Better off here anyway. Jesus, what did he back into?' The doctor bent down to inspect the wound as they moved. 'Must be a hundred pellets in there!'
'Wait till you see the neck,' Eaton told him.
'Shit...' the resident breathed.
They wheeled him into the capacious emergency room, selecting a cubicle in the corner. The five men moved the victim from the gurney to a treatment table, and the medical team went to work. Another physician was standing by, along with a pair of nurses.
The resident, Cliff Severn, reached around delicately to remove the cervical collar after making sure the head was secured by sandbags. It took only one look.
'Possible spine,' he announced at once. 'But first we have to replace blood volume.' He rattled off a series of orders. While the nurses got two more IVs started, Severn took the patient's shoes off and ran a sharp metal instrument across the sole of his left foot. The foot moved. Okay, there was no immediate nerve damage. Good news. A few more sticks on the legs also got reactions. Remarkable. While that was happening, a nurse took blood for the usual battery of tests. Severn scarcely had to look as his well-trained crew did their separate jobs. What appeared to be a flurry of activity was more like the movement of a football backfield, the end product of months of diligent practice.
'Where the hell's neuro?' Severn asked the ceiling.
'Right here!' a voice answered.
Severn looked up. 'Oh - Professor Rosen.'
The greeting stopped there. Sam Rosen was not in a good mood, as the resident saw at once. It had been a twenty-hour day for the professor already. What ought to have been a six-hour procedure had only begun a marathon effort to save the life of an elderly woman who'd fallen down a flight of stairs, an effort that had ended unsuccessfully less than an hour before. He ought to have saved her, Sam was telling himself, still not sure what had gone wrong. He was grateful rather than angry about this extension to a hellish day. Maybe he could win this one.
'Tell me what we have,' the professor ordered curtly.
'Shotgun wound, several pellets very close to the cord, sir.'
'Okay.' Rosen bent down, his hands behind his back. 'What's with the glass?'
'He was in a car,' Eaton called from the other side of the cubicle.
'We need to get rid of that, need to shave the head, too,' Rosen said, surveying the damage. 'What's his pressure?'
'BP fifty over thirty,' a nurse-practitioner reported. 'Pulse is one-forty and thready.'
'We're going to be busy,' Rosen observed. 'This guy is very shocky. Hmm.' He paused. 'Overall condition of the patient looks good, good muscle tone. Let's get that blood volume back up.' Rosen saw two units being started even as he spoke. The ER nurses were especially good and he nodded approval at them.
'How's your son doing, Margaret?' he asked the senior one.
'Starting at Carnegie in September,' she answered, adjusting the drip-rate on the blood bottle.
'Let's get the neck cleaned off next, Margaret. I need to take a look.'
'Yes, doctor.'
The nurse selected a pair of forceps, grabbed a large cotton ball, which she dipped in distilled water, then wiped across the patient's neck with care, clearing away the blood and exposing the actual wounds. It looked worse than it might really be, she saw at once. While she swabbed the patient off, Rosen looked for and got sterile garb. By the time he got back to the bedside, Margaret Wilson had a sterile kit in place and uncovered. Eaton and Marconi stayed in the corner, watching it all.
'Nice job, Margaret,' Rosen said, putting his glasses on. 'What's he going to major in?'
'Engineering.'
'That's good.' Rosen held his hand up. 'Tweezers.' Nurse Wilson set a pair in his hand. 'Always room for a bright young engineer.'
Rosen picked a small, round hole on the patient's shoulder, well away from anything really vital. With a delicacy that his large hands made almost comical to watch, he probed for and retrieved a single lead ball which he held up to the light. 'Number seven shot, I believe. Somebody mistook this guy for a pigeon. That's good news,' he told the paramedics. Now that he knew the shot size and probable penetration, he bent down low over the neck. 'Hmm... what's the BP now?'
'Checking,' another nurse said from the far side of the table. 'Fifty-five over forty. Coming up.'
'Thank you,' Rosen said, still bent over the patient. 'Who started the first IV?'
'I did,' Eaton replied.
'Good work, fireman.' Rosen looked up and winked. 'Sometimes I think you people save more lives than we do. You saved this one, that's for damned sure.'
'Thank you, doctor.' Eaton didn't know Rosen well, but he made a note that the man's reputation was deserved. It wasn't every day that a fireman-paramedic got that sort of praise from a full professor. 'How's he going to - I mean, the neck injury?'
