He Knows What It Means

Ron Riekki

Everyone in the car is dead.

The medic tells me this.

I say, “Everyone?”

And he says, “You don’t believe me?”

“I do.”

He says, “Maybe you’re right” and hands me the b.p. “Go ahead,” he says. “It’s good training.”

“But they’re dead.”

“Verify it. Make sure they’re dead.”

He heads back to the ambulance, stops halfway, looks back. He sees me following, walking towards him.

“Stethoscope,” I say.

I’d left it in the ambulance.

“Why are you leaving your stethoscope in the ambulance?”

No need to answer.

“You’re supposed to always have it on your neck.”

What kind of a name is that?

He’s from Alabama.

I said I was a Florida fan and from that point on, he hated me. Keeps mentioning the Tigers. Says war eagle to me when he sees me at the time clock, punching in, 0700 hours, twice a week. When he says it, he emphasizes the war. He reminds me of an overseer. And he’s my partner. You can’t switch partners either. Not unless one of us dies. Or quits. And I’m not quitting. I can’t.

I grab the stethoscope, the ambulance warm. I sit for a second, breathe. They told us to do that in EMT school. If you ever think you might faint, breathe. If you see something so gross it makes you feel dizzy, then breathe. The breath controls everything.

I grab a mask. Put it on.

I walk out.

He laughs.

I walk by him.

He used to be a football player. Some high school not in Auburn. Opium, it sounded like. Opium High School. I swear, that’s what he said.

I’m from Québec. Originally. Montréal. Ouestmont. The English-speaking part of Montréal. Most French sounding name possible—Ouestmont. And everyone speaks English there.

He can’t believe he has to work with a Canadian. A foreigner. We’re a match made in hell. But my mother keeps telling me this is God’s way of making me understand people. That if I have prejudices against conservative people, then I need to work those out.

I used to not believe in God.

And before that, I believed in God.

Now I’m sort of not believing again.

They say everyone prays in foxholes. What they don’t tell you is that they’re praying because they don’t believe. You really believe. I mean, really. You don’t even have to pray. You just know.

I’ve never seen a dead person. I got through EMT school without any corpses. Only photos. As far as the ambulance, when I did my training, everyone lived. We hauled some messed up people, but they came on breathing (mostly) and left breathing (mostly).

All my clinicals, I never even did CPR. I’ve still only done it once. It was boring. I thought it would be exciting, but it was just exhausting. I just remember sweating down on the grandmother, counting, thousand-one, thousand-two, thousand-three. Keeping to the rhythm of “Staying Alive,” that old song by John Travolta. It’s the perfect pace to do CPR. “Stayin’ alive, stayin’ alive.”  My sweat drops collected on her breast. It made me never want to have sex again.

I walk up to the car.

This is Alachua, by the way. Not Alabama. Not Opium or wherever he’s from.

Jasper lives in Dothan but commutes to Florida, because Alabama has the worst pay for paramedics out of any state in the country. It also has, if I remember correctly, the highest death rate for cardiac arrest. Because they pay their paramedics the worst of any state in the country. So he drives four hours for each shift, four hours back. Luckily, it’s 24-hour shifts. Two per week. A 48-hour workweek and you only work two days. He said you only get that in America.

The car was on fire.

Then it went out. On its own. We waited. Soon as we were sure it was completely out, we went up to the car. We could have waited for the fire department, but there was a MCI in Gainesville. We figured it’d be too long of a wait. And the car, the way it looked, we figured we didn’t need a fire department. We needed a coroner. So we’re waiting for one.

I threw pebbles at a tree while Jasper did the vitals on all the corpses. I mostly missed the tree. Then hit it hard and he yelled cut it out.

I did.

It’s obvious they’re dead.

They said that in EMT school, that you’ll just see a person and know. Just know they will never breathe again.

They hit a tree at 70 or 75. Maybe 80. Probably fell asleep at the wheel. We get a lot of those here. One SUV, it turned upside-down, traveled a couple football fields like that. The whole family too panicked to scream. No one got hurt. How would you like to be that father?  Almost kill your whole family. When all you needed was a nap. A hotel. He wanted to save money on a room. Now he has to buy a new vehicle. And the kids, his wife, will never trust him again.

These are my first corpses.

And part of me feels I need this.

I’ve suffered depression my whole life. The reason I wanted to become an EMT. To help people. And I also thought seeing real suffering would make me appreciate life more. It didn’t. It just makes me more depressed. But I keep trying.

Jasper said it was football that did it for him. An AC injury. He went to the hospital and saw a bunch of Porsches and BMWs in reserved parking spots and asked, “Who’s those for?”  He said he saw how much nurses and doctors make and said he wanted some of that.

He’s a medic.

Medics make crap.

EMTs, worse.

I lean in through the window. The glass shattered. Jasper stomped down what was remaining.

The smell is gas. A leak. With the car previously on fire, part of me is ready to dive at any moment. My heart, tachycardic. Hard to take good vitals like this. But it’s quiet. So quiet. The occasional semi passes and covers everything, but mostly it’s nothing, birds, nothing.

The blood is pooled so deep that you can’t even see floor mat. They have femoral breaks, multiple, open fractures. Probably everyone in the family. That’s a liter in each femur, so there’s like eight liters of blood on the floor.

Take two, three gallons of milk. Pour it out. Fill those gallons with blood and then splatter and pour them out in a car and you’ll have an idea of what I’m looking at.

I don’t speed anymore. You see this a few times and you’ll drive 55 miles per hour on the nose. Let the whole world pass you. They’re heading to their deaths.

Everyone is in the front seat.

Four people in the front seat.

This is what happens when you don’t wear seatbelts. The people in the backseat become people in the front seat.

Luckily, they didn’t go through the windshield. That happens a lot. You walk up to a car that’s completely empty. Figure they fled the scene. An alcoholic that just ran. Plans to get caught later, when sober. But you look and up ahead, ten feet, twenty, forty is a body, hidden in some field. Jasper said one time they found a man up in a bunch of tree branches. Dead.

I put the stethoscope to the father’s chest. The driver. He looks as if he fell asleep after a shower of blood. I pray when I do this. Our father who art in heaven hallowed be thy name. To myself. I listen for lung sounds. I lift his shirt up. Nothing. I auscultate times four. The sound of nothing. I always wonder if there’s something wrong with the stethoscope. I get it sometimes with perfectly healthy people, nothing. The same joke, “What, am I dead?”  Luckily, Jasper moved the dad back for me. His air bag didn’t deploy. It happens. The passenger side did. But not driver side. It looks like his throat hit the steering wheel. His neck is at an angle you can’t have and live. I don’t take a b.p. on him. If Jasper asks me, I’ll make one up. His diastolic was zero. His systolic was zero. Then I realize he’ll probably have me fill out a PCR, and I can’t fabricate numbers, so I take it. I slide the cuff around the arm.

It’s cold. January. Northern Florida. Yes, it can get cold here. In the thirties. Twenties. It’s in the forties now. High forties. I like when it’s cold. I heard more patients live when it’s cold. And if it’s corpses, it’s good too—the body will be kept longer, will rot less. They’ll look good for the funeral, the open casket. Cold weather is good for the living and the dead. It vasoconstricts. Lessens bleeding. Lowers swelling. Mother Nature as medicine.

I pump up the sphygmomanometer. Release. Listen. I feel for a pulse. I look for chest rise. I test capillary refill. He’s dead. Dead. Dead. Dead. Dead.

I asked for this. Big mouth.

I look back in the ambulance. He’s inside. Probably watching in the rearview. Listening to god-awful classic rock. Led Zeppelin. For the millionth time. If I have to listen to him hum to “Whole Lotta Love” one more time, I’ll check myself in as a psych patient. Thank god he listened to my insistence on no country. That I couldn’t take.

Upside-down is the son. He’s face down in the blood, the pool. I don’t want to lean in that far, so I decide to skip vitals on him. He’s drowned in blood. There’s no use. And something about the position, his feet up where his head should be, it just feels pointless. And too much risk.

I go to the other side. The window isn’t broken.

I open the door.

The mother has severe airbag burns. She looks so sad. So red. She’s bit her lower lip off. I won’t tell you all of the details. He’s right. I’m wrong. This is my lesson. Here, you look at it up close. Here, you breathe in that chemical airbag smell. Here, you feel a lack of pulse. I do. Her arm, so limp. So frail. So gentle. So healthy. So alone. With her family.

Books thrown about. Everything in the backseat becomes everything in the front seat. A Bible. Several children’s books. A coloring book, of the human body. I open it. I see a heart. The whole thing colored red. Perfectly staying in the lines.

The mother’s daughter is in a pile. Crumpled. The human body can take so many shapes. I saw photos of the people who jumped on 911. They showed us these in EMT school. I cried after that class. The only time I’ve cried. Me, wiping my eyes in traffic. They didn’t look human. The daughter doesn’t look human. She’s horror-movie crooked. I auscultate. The sound of a semi in her lungs. The sound of birds in her lungs. The sound of nothing. The sound of nothing. I feel a radial. Nothing.

I remember in school that they told us to take a pulse on both arms. I asked why. I can’t remember what the guest instructor said—maybe it was aortic dissection, a condition that can cause a pulse on one arm and not the other. I take the pulse on the daughter’s other arm, leaning in, on the mother, pressing against this dead woman. Nothing. I can hear the guest instructor’s voice. To wait. Telling us to wait. To count longer. If a patient is hypothermic, it can take longer for a pulse to register, that your hand can warm their skin, that it might be there. Faint. I wait. The quiet of time with the dead. The sound of wind now, that I’d missed before. My hearing so intense, as if I might hear a pulse. The wind like ghosts, a moan, like a fire, like water flowing. And then, so faint, so easy to miss, I feel it. A pulse. I’ve heard of this, that it could be my own, that I could be imagining it. But I wait. Me and the dead daughter and the wind like an eraser. And I feel it again. So weak. So subtle. And then I yell. Bring everything.

I yell again. Bring everything!

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Ron Riekki’s books include U.P. (Great Michigan Read and Sewanee Writers Series nominated) and The Way North: Collected Upper Peninsula New Works (2014 Michigan Notable Book and finalist for the Foreword Book of the Year in the Anthologies category).  His fiction, poetry, and non-fiction have been published in New Ohio ReviewSpillwayJukeddecomPPANKPithead Chapel, and many other journals.  He has books upcoming with Michigan State University Press and Arbutus Press and is at work on a novel.