The frantic, comical waving stopped as soon as I was within a few feet of him. “She just stopped breathing before you got here… and I think she used to have a pulse, too!”

That’s probably a safe assumption.

As soon as MPD’s latest hero stepped from between the cars, I could see the full extent of her injuries. No, she wasn’t breathing. No, I couldn’t find a pulse. Oh, and she had so many holes in her that I didn’t have time to count them all right now. Stomach, torso, arms… she looked like an extra in a B-level slasher movie.

The wounds that concerned me the most were currently making a faint whistling sound. Two new openings to her trachea had been made, and both were leaking air as fast as we could force it in with the bag.

Someone started chest compressions. The sirens in the distance told us that we had a minute or two until the ambulance arrived, so I glanced behind me and grabbed my tube kit; as I turned around and opened the laryngoscope with a neat snap, I saw the ramifications of our first round of CPR.

With every mushy compression, more of her insides became outsides. Her abdomen had been opened with such force and depth that various parts of her which were never meant to see daylight now became available for full visual inspection.

Dammit. Well, let’s see if this works.

The tube passed through her vocal cords. I withdrew the stylet and squeezed the bag; hopefully the cuff was placed far enough beyond the wounds to make it to the lungs. Her chest rose and fell, rose and fell.

After a few more breaths, I slid my hands under her shoulders and helped lift her to a backboard. She was slick with blood, and surprisingly heavy in the way that only a dead weight can be.

Straps, bloody sheets, the thunk of the stretcher lock slamming home.

We slapped big defibrillator pads and occlusive dressings on her torso with equal speed. Behind me, I heard a radio squawk out our destination hospital as I looked at the monitor. There was electrical activity present, but it wasn’t actually making her heart move. Keep pumping.

I listened with a stethoscope to make sure the tube was in her lungs. It was properly placed, but each breath sounded like a dishrag being wrung out. Her chest was filling with blood, and the pressure increased every minute as we bumped down the road.

Our verbal report felt futile. 31-year-old female, multiple stabbing. Trachea, chest; abdominal evisceration. Pulseless and apneic on our arrival. Still no pulse, got a tube for ya.

The ER only worked her for a minute or two. A nurse approached the bed with a chest tube tray, but was waved off by a tired-looking doctor.

No, no need for any of that… time of death, 1759 hours.

—————

The smell of blood mixed with stale tank water overcomes your nostrils quickly, almost overwhelmingly. A funny thing about being a paramedic on an engine company: sometimes our versatility confounds my impersonality. Usually, it’s not an issue for me to remain clinical and detached. As providers, we’re asked to treat young and old, grateful and ungrateful all the same. Dead, living, whatever the call is; do your job and go on the next run. But even before we heard the story of who did it and why, we could tell that this was a very hateful—and very personal—attack. It turned out to be petty shit; and although I wasn’t thinking about it at the time, there’s a bit of retroactive anger and disgust when the engine is called back to wash someone’s handiwork off the asphalt. Handiwork that we lifted not eight hours ago, dripping and glassy-eyed, into an ambulance for the first of her last trips. The hearse will come soon after; the final ride may depend on what you believe in.

The ancient Greeks called for a coin in the mouth of their dead to cover the cost of the ferry to the underworld.

I hear Charon is quite particular about paying up front.