"You can't die Mr. Blackmore," I told him. "Until you learn to get used to me dating your daughter. I won't allow it."
He actually chuckled at that.
From outside came the sound of approaching sirens.
Chapter 12
The paramedic and the EMT that showed up were both strangers to me. Probably they were people that had worked briefly in the field and then had gone onto other things; the fire department, the police department, nursing, medical school. They came in the door shortly after the fire engine crew had barged in. I was glad to see that the paramedic took Mr. Blackmore's condition as seriously as I did. I stood back and said nothing, feeling confidant he was in good hands.
While the paramedic went through the routine questioning, questions I was very familiar with, his partner hooked up the EKG machine. It was an older model of the device, a model I was unfamiliar with since it had been replaced long before my debut in the medical field, but the display was the same. I saw the rapid complexes of his normal heartbeat intermixed with frequent premature complexes; beats that were not perfusing much blood, beats that were the telltale sign of a very irritated heart. Worse still was the fact that sometimes Mr. Blackmore would have fifteen to twenty of these premature beats in a row. This was known as ventricular tachycardia, or V-tach, in medical circles and it was very dangerous. It was, in fact, only a step above complete cardiac shutdown.
The paramedic, a young, blonde man whose hair was probably a little longer than was allowed, saw the display and tightened up almost inperceptively. He glanced at his partner for a moment and a look was passed between them; a look that the ordinary citizen would not have even noticed but which I was well versed in. It was a look that said "Holy Shit!".
"Set me up an IV." The paramedic told his partner calmly, as if this was a perfectly normal request. It wasn't. Usually IV's were not started on scene.
"Right." His partner nodded, going for their medical box.
"Put him on high flow oxygen." The paramedic told one of the firemen.
He went mechanically about the task of installing the IV line into Mr. Blackmore, speaking soothing words to him the whole time, telling him what he was going to be doing. On the other arm a fireman was taking his blood pressure. He shouted out the reading when he had it.
"Ninety-four over forty." He said.
The paramedic digested this, chewing on his lip thoughtfully for a second. That was not the greatest blood pressure in the world in relation to a cardiac event. Finally he plugged in the IV and taped it down.
He injected some lidocaine into the IV port and watched the display on the EKG. The lidocaine was supposed to numb the heart a little, making it less irritable and less likely to throw premature beats, go into V-tach, or, worst of all, go into fibrillation. The runs of V-tach slowed a little, becoming less frequent and shorter in duration when they did come. Not the best thing in the world but better. Hopefully it would be enough to deliver him to the hospital alive.
"Let's get him out of here." The paramedic said.
Mr. Blackmore was loaded up onto their gurney and rushed out of the house to the waiting ambulance. Mrs. Blackmore was placed in the passenger seat by one of the firemen. Another fireman climbed in the back with the paramedic.
Again this probably seemed routine to the average person and again it wasn't. A paramedic only took a fireman in with him when he thought that he might need an extra hand on the way to the hospital. In other words, when he thought there was a good possibility that CPR was going to need to be performed at some point. Runs of V-tach had a nasty tendency to degenerate into a full-blown cardiac arrest.
The ambulance headed to the hospital with lights and sirens on. The remaining firemen climbed into their engine and drove off behind it to pick up their crewmember. That left Nina and I alone at the house. She was scared, as scared as anyone I'd ever seen before.
"Bill," She asked me. "Is he going to be all right?"
"I hope so." I told her, wiping a tear from her eye. "Why don't you go get dressed and we'll drive down there?"
She nodded and rushed into the house.
We arrived at the hospital and found Mrs. Blackmore in the waiting room amid a full house of sick, injured, and others that were waiting their turn to be seen. She was sitting bolt upright in one of the plastic chairs, wringing her hands together nervously, ignoring the babble of conversation and the wall-mounted television that was pumping out a mindless sitcom.
"Mom?" Nina said, grabbing the seat next to her. "Have you heard anything? Is he okay?"
Mrs. Blackmore looked at her for a second and then at me. She swallowed and then hugged her daughter briefly. "No." She said. "They put me in here as soon as we got here. Nobody's been back to talk to me yet."
"Did anything happen on the way in?" I asked her.
She looked at me, wanting to be offended by my presence with her family on this occasion but she simply couldn't muster the will to do it. "No." She shook her head. "The paramedic gave him some sort of injection about halfway here, but nothing else happened."
I nodded, heartened by the news that he'd hung in there on the trip. We waited, speaking little to each other.
It was about ten minutes before a doctor came out to speak with Mrs. Blackmore. Again, he was no one I recognized although I had learned to know all of the ER docs in my time as a paramedic. At some point he would probably move on to other things. I only hoped he was competent at what he did. Some weren't.
He invited Nina's Mom back to a private consultation room. Nina stood and went with her. After a moment's hesitation I did too. Nobody offered protest to this. We all took seats in a tastefully decorated room with several comfortable chairs, a couch, and a telephone. Again my knowledge of how things worked in the ER told me a lot. The absence of the hospital chaplain bespoke the fact that Mr. Blackmore was still hanging in there.
"Your husband has suffered a very significant myocardial infarction." The doctor explained once we were settled in. "In layman's terms, that is a heart attack."
"Will he be okay?" Mrs. Blackmore asked, wiping her eyes with a tissue from the box near the telephone.
"It's too early to tell." He said. "But the fact that he was brought to us so early in the process is encouraging."
"What do you mean?" She wanted to know, encouraged by the word "encouraging".
"Well," He explained. "A heart attack is basically a clot that has become lodged in the coronary arteries, these are the arteries that feed the heart, blocking the blood flow and therefore the oxygen. If nothing is done about it, then the tissue that is deprived of oxygen will die in a few hours and will never again be able to help pump blood. I must tell you that in an attack of this size, if something like that were to happen, your husband's chances of surviving more than a month or two would seriously be in question. He would most likely develop congestive heart failure.
"But since he got to us shortly after the onset of symptoms there are things we can do to get rid of the clot."
"There are?" She asked.
"Yes." He nodded. "There is a procedure known as cardiac catheterization. What we do is send him to a room in the hospital where a cardiologist will insert a catheter, a thin sheath, into one of his veins. We will thread this all the way to the coronary arteries and then inflate a small balloon in the catheter with air. This will push out the obstruction, returning blood flow to the tissue that is deprived. Now the science is inexact, and there will still be some damage to the heart, but it will be much less than what it would have been."
"So he'll be okay?" She asked hopefully.
"With a little luck," He said, "Your husband will be able to resume a normal life in a few months. He might require a bypass operation to divert flow around the compromised arteries, but yes, if this is successful, he'll probably be all right."