Jim, by now a veteran of air travel, planned to sleep the entire way back to LAX. Life as part of a touring rock group was fun, exciting, and everything he had ever dreamed it would be (and quite a bit more), but it was exhausting. The days and nights rolled by in an endless stream of arenas and hotel rooms, charter flights and catered food, booze and groupie sex. Sleep was sometimes left on the back burner, particularly when they had multiple travel days in a row. Jim had fucked some of the most beautiful and uninhibited women imaginable throughout this adventure (though he had not kissed a single one after Matt advised him why he should not), sometimes two at a time, and, on one occasion, three at a time. But the trip was also taking a toll on his body. He hadn’t weighed himself since the trip started—he didn’t want to know the real number—but he was pretty sure he had put on at least ten pounds, maybe more. The lack of exercise combined with the catered food and the booze had stretched his waistline out and added a noticeable spare tire at his midsection. He had to buy a whole new set of jeans and shirts back in Baltimore because his old ones didn’t fit anymore.
I really need to hit the gym over the break, he thought as the plane climbed into the sky and settled on its first leg of the journey. Cut out the booze too. God only knows what this is doing to my blood pressure. That was something else he had not measured during this adventure, again, because he really did not want to see what the number was.
By the time the plane leveled out and started its cruise phase, Jim was asleep and snoring lightly. He did not wake up when the front flight attendant came around asking for drink orders. He did not wake up when the plane hit a particularly nasty pocket of clear air turbulence just north of Mobile, Alabama and several carry-on bags came tumbling out of the overhead compartments. He descended all the way down into REM sleep and likely would have remained there until at least New Mexico or Arizona, had duty not called.
“Jim!” a voice said into his ear. A hand was shaking his shoulder. “Wake up, dude! Matt needs you!”
Sleep fell instantly away from him, jerking him out of dream in which he had been trying to find his way out of a large house because something was after him. He blinked his eyes a few times and stared into the face of Austin Jefferson, the bass player. Austin looked scared. The words he had just said were processed and understood and Jim sat up straight in his seat. “His heart again?” he asked.
“Yeah,” said Matt’s voice from the seat in front of him. “It’s fuckin’ doin’ it again, dude. This shit is getting old.”
“It” was the supraventricular tachycardia that Matt was plagued with, the reason Jim was employed by him as a personal paramedic. This was not the first time Matt had gone into SVT since Jim had joined him on the tour. He had had a brief episode after the show in Virginia Beach two weeks ago (right after snorting some post-show cocaine) but it had stopped on its own before Jim could even start an IV on him. And then, just the week before, before the show in Charlotte (more than ten hours after Matt’s last line of coke) it happened again. This time Jim was able to start an IV and give him six milligrams of Adenosine, which converted him back to a normal rhythm in about fifteen seconds. Despite Jim’s stern advice to the contrary, Matt had gone on with the show after the conversion, performing the entire set and then snorted coke and bagged himself a two by four afterword.
Jim quickly unbuckled and stood up. In addition to Austin, Greg Gahn, Corban, Steve, Jack Ferguson the security chief, and Diane the cute blonde flight attendant, were all standing around the general area, their faces worried.
Jim stepped forward and looked at his boss/patient. Matt was pale, a little sweaty, his seat reclined slightly, his expression one of resigned fear. A half empty glass of Jack and Coke stood on the tray table before him and the video screen was showing a movie with lots of scantily clad women in it.
“Did it just start?” Jim asked, reaching down and grabbing Matt’s wrist.
“Yeah,” Matt said softly. “About two minutes ago; started out of fuckin’ nowhere. It’s running like a freight train. I can feel it.”
Jim found Matt’s radial pulse with his fingers. He did not need to count it. Matt was right. It was running like a freight train. It was time to earn his money.
“Austin,” he said, “grab my football out of the overhead.”
“Right,” Austin said, reaching up and unlatching the compartment.
“How are you doing otherwise, Matt?” he asked. “Any chest pain?”
“A little tightness,” Matt said. “Not too bad.”
“How’s your breathing?”
“I feel a little winded,” Matt admitted.
“You do seem to be a bit tachypneic,” Jim agreed. “The air pressure at cruise altitude is kind of low. It’s like standing on top of a mountain. That might be what triggered it.”
“I don’t give a fuck what triggered it,” Matt said. “Just fuckin’ fix it.”
“I’ll do my best,” Jim said, taking the football from Austin. He set it down on the floor of the aisle and opened it. He pulled out the LifePak monitor and turned it on. While it went through its self-checks, he opened the pockets and pulled out the cables and a package of electrodes. “All right, Matt,” he said. “You know the drill by now. Get your shirt off.”
Matt pulled off the Gator Bar t-shirt he had picked up in St. Petersburg three nights before, revealing his bare chest and the upper parts of his full sleeve tattoos. Jim quickly applied the sticky electrodes to the front of both shoulders and to both sides of his lower abdomen. He then looked at the monitor screen, which was, by now, showing a display. He did not need to print out a strip to analyze the rhythm (but he did so anyway, for documentation purposes). It was a classic SVT, trucking along at 210 beats per minute.
“Yep,” Jim said. “It’s the SVT all right. Let’s see how the blood pressure is doing.”
He pulled the blood pressure cuff and the stethoscope out of the football and fastened the cuff around Matt’s left upper arm. He put the stethoscope in his ears and the bell to Matt’s inner elbow. He pumped up the cuff to 180 and then slowly released the air, listening for the beat of the artery to return, his eyes watching the needle of the gauge. The beat returned at 106. It disappeared again at 62. Jim nodded happily and let the rest of the air out of the cuff.
“Well?” Matt asked.
“You’re not hypotensive,” he reported. “One-oh-six over sixty-two.”
“You won’t have to light me up then?” Matt asked.
“Not as long as you convert with the Adenosine,” Jim told him. “Let me get an IV started.”
“Do it, dude,” Matt said holding out his arm.
Jim reached back into the football and pulled out a bag of normal saline and a set of IV tubing. He opened the packages and started to assemble them.
“Should I let the captain know we have a medical emergency?” asked Diane, the flight attendant. She looked even more nervous about all this than Matt.
“Naw, baby,” Matt told her. “I’ll be all right in a few minutes, as soon as my man here gives me the shit.”
“The shit?” she asked.
“He should be okay,” Jim told her. “We’ve been through this before.”
“That’s why Jim is here,” said Austin. “He fixes hearts.”
She looked doubtful about this but stayed where she was.
Jim handed the IV bag with the tubing now dangling out of the bottom to Corban. “Here,” he said. “Hold this up.”
“Right,” Corban said.
Jim opened the clamp until the saline started to drip out of the end of the tubing and then closed it again. He then pulled a 10ml saline flush and saline lock out of the football. He screwed the latter onto the former and then flushed the lock of air. He set it down next to him and then pulled out an IV start kit and opened it. Inside was a blue latex tourniquet, a couple of sterile 2x2 pads, two alcohol preps, a sterile transparent dressing, and a small roll of medical tape. He tore three strips of the tape and stuck them to the leg of his pants, right at the thigh. He then took the tourniquet and tied it around Matt’s upper arm, above the elbow. Matt had good veins and he had a variety to choose from. When giving Adenosine, however, the closer the vein was to the heart, the better the medicine worked. It only had a half-life of a few seconds once injected, so the shorter the trip and the faster it was infused, the better. He touched the large antecubital vein right in the crook of Matt’s elbow. It was fat and springy. It was the same place Jim had started the IV last week as well. The fading bruise of that cannulation was still visible.