The Aleph
Chapter 1: Vectors; part 3
Read parts 1 + 2 here
Trevor stepped next to Jadas’ stretcher. She was hidden in her hood but she saw him approach from a crack and now he stood over her silently. She turned her head and met his eyes.
“Can I go now?”
“I couldn’t tell if you were awake.”
“I can’t sleep like this. I’ll be up all night.”
“Your lab work all came back, it looks. You can go to detox now.”
“Finally.”
“You don’t take anything for your seizures? We didn’t check any medication levels and your chart is blank.”
“The doctors wanted me to take a bunch of shit but I haven’t in years.”
“When’s the last time you had a seizure?”
“I don’t know like two years ago? I take Ativan and Klonopin a lot for my anxiety and it keeps the seizures away.”
“That’s not in your chart either.”
“Well. Fucking put it there I guess.” Trevor chuckled at that.
“Those aren’t really medications for epilepsy,” he said smiling, “when you’re in detox you should tell them to start you one something.” He kept looking at her and she didn’t know what to do, so she looked down. “If you really have seizures.” He added. She looked back at him and quietly said
“I do.”
“Ok. Well let’s go then.” He stomped the locking lever on the stretcher to the steer position and pulled her bed out from the line up and pushed her down the hall. It suddenly occurred to him that she was probably very cold and as they walked by the blanket station he grabbed two and stopped to open them and drape them over her. She wrapped them around herself and adjusted her hips.
“Thanks” she said, and he started again. They rolled past several people in the halls sprawled or huddled on stretchers, one laying back with her eyes closed and an IV drip infusing through a machine into her arm. There was a couple sitting on another one and Trevor wasn’t sure which was the patient, and there was even a man handcuffed to a stretcher overseen by two bored looking police officers. Everyone watched them as they went by. Jada tried to peer into the rooms they passed but it was impossible to see anything more than the periphery of cardiac monitors and disheveled linen sticking out from the edges of drawn curtains, although as they turned a corner they did hear some screams coming from far off.
“Whoa” she said. “What do you think that was?”
“Some crazy person” Trever replied. Jada laughed at that. “The trauma rooms are pretty far from here, it’s probably some nut. Or someone making a big deal out of nothing.”
They proceeded away from the area where patients were kept and turned to a short, unadorned hallway cluttered with medical equipment all shoved together into a tangled mash of ventilator tubes and spotlights on angular arms, infant warmers and AEDs with cords and coils spreading everywhere. They turned again into a long corridor lit dimly now with metal plated walls and a dirty floor. This was the hallway to the vast operating rooms and adjoining waiting and holding areas, but at this hour of the night it was silent and abandoned. Trevor walking rapidly down the hall and came to the OR doors and turned so fast he almost slammed Jada into the wall, but he grabbed the stretcher rail and stopped it, guiding it around the corner to come to the opposite facing elevator. He pressed the button and turned to look at her, noticing for the first time how attractive she was. The elevator dinged and he backed into it with her and pressed 8.
“Elevators scare me” she said as the door closed.
“Shooting heroin is scarier,” Trevor replied, which also made her laugh.
“I guess so.” Trevor stared at her face and she didn’t look back. He knew he must be making her uncomfortable but he couldn’t look away. Her lips were lined with thin black pencil and her jaw was delicately bold. She wore a black hooded sweatshirt with an ornate crystal dagger on it and “Crystal Blade Tattoo” written in what looked like aqua glass shards.
“You work there?”
“Where?”
“Crystal Blade.”
“Yeah,” she said flatly.
“You do ink?”
“No” she laughed, “I just work the front desk.” Trevor couldn’t see any tattoos on her except a few blurred black runes on a few fingers. He kept eying her as they ascended in silence. She brushed her hair behind her left ear, and he noticed black polish on her short nails. “I draw though” she added.
“Awesome” he said. “I hope they let you draw in rehab.”
“Probably not” she said, and laughed again. “they don’t let you do shit.” The elevator stopped, the door opened, and Trevor pulled the stretcher out.
“You’ve been?”
“No” she admitted, “but I know they don’t let you do shit there. It’s like prison.”
“No it isn’t” he said. She smirked and looked around.
“I probably could’ve walked you know” she said.
“Yeah force of habit. Take the free ride.” They turned down the empty hall and came to a door with no handle or window. Trevor pressed the intercom just as Jada said
“Jesus it looks like fuckin jail. I told you”
“I know. It’s only locked from the outside though, to keep people from getting in. You should see the shit some of these addicts pull, dealers trying to bring shit in or patients sneaking out to smoke and bring something back or whatever.”
“Yeah I bet. I’m not gonna do that. Why would I come if I don’t want to be here.”
“I don’t know. Some people get really fucked up and march themselves down here like every day.”
“Haha no shit.”
“Yeah, usually the drunks. Junkies mostly don’t come around until they’re mandated by the court.”
“I’m not mandated by the court, I just need to get off this shit. I broke up with the asshole who got me on it and now I need to work on starting my life over from where I left off.”
“Sounds like a plan” Trevor said and hit the intercom button again. Soon a voice came on and said:
“I’m up here by myself you just have to wait,” but the door buzzed and Trevor pushed it open. They entered another quiet, shorter hall, this one with a few chairs opposite another handless door and a window to a small booth.
“Is that the detox nurse?” Jada asked, looking at the massive woman wearing spectacles on the end of her nose.
“No, that’s Cherise, she’s a peach” Trevor answered. Jada laughed. Cherise ignored them, frantically shifting papers, leaving her booth and coming back, writing things, stacking, leaving again.
“You seem like you’re in a better mood.”
“Yeah I still feel like shit.”
“Just happy to be having some progress?”
“Yeah I was in the ER fucking forever”
“It wasn’t forever.”
Cherise came back to the office and sat down without looking at them.
“I have to get back downstairs the place is falling apart” Trevor said into the glass. Cherise looked up at him and froze. They locked eyes for a moment and neither moved.
“Honey just put her little ass in that chair right there and get yourself downstairs.” She went back to her paperwork. Trevor turned to Jada and shrugged, holding up the lever on the stretcher and lowering the railing. He took the blankets off her and said “I can cover you again when you sit down. Do you need help getting up?”
“No” she sighed, easing out of the stretcher and leaning into the chair. Trevor placed the blankets on her and wrapped them snuggly around her shoulders. She looked at him and smiled weakly.
“Sorry to leave you here with her” he said. She laughed.
“I’ve seen worse.” He pressed the release button on the door and backed out. As the door shut he looked back at Jada and caught her look at him and wave feebly.
The quiet hallway was a bit claustrophobic and, because detox was on the top floor, the ceiling ran with exposed pipes. Narrow and weakly lit by dusty, dying lightbulbs, the hallway ran down to another metal door with a big red “NO ACCESSS” sign. Trevor knew it went to the roof and the helicopter pad, though this was for maintenance, the patients and medics used a different elevator. He heard a helicopter coming in now as he hit the button and waited for the elevator he wondered what it brought. As he pressed the elevator button he breathed a hard breath, knowing once he got downstairs he would be thrust back in to the mess, and the doors opened. He stepped on and pulled the empty stretcher in and stood motionless as the door began to close. A pipe clacked and some exhaust vent banged to life down the hall.
Once on the ground level the doors opened and deposited him in front of the OR, and he turned back towards the ER. As he proceeded he noticed a big splatter of blood on the floor that wasn’t there before, and he wondered who it was from. As he returned to the ER he dropped the empty stretcher off in a back hall and hurried through the empty corridor and stopped for a second. He was in the usually busy passage that was the confluence for the OR, trauma, acute medical, and acute pediatric areas. This was where all critical patients were rushed, either out to the OR and ICU’s, or in from the helicopter. On truly manic nights even this hall was lined with stretchers full of patients, but now it was the only silent place he had found all night, and he stopped to revel in it.
After a few breathes he began to feel a depth to the air, a potential energy that he imagined walking through a subtle static electricity field might feel like. It resonated with the buzzing fatigue in his head that hadn’t gone away, but now it seemed to emanate from his consciousness to infuse space with tingling invisible energy. He turned around slowly and perceived a viscosity to the air and he knew was related to all the people who’d died in here. Their spirits must’ve been trapped here, and he could feel them. It wasn’t like what he was told as a child, ephemeral holograms floating about lost, passing through people and walls. It was a texture to the air, the undissipated entropy of so many dying bodies clustered in one place, the carcasses removed for storage and disposal while the liberated heat energy lingered.
He stood motionless and watched the fuzzy emptiness, feeling it’s heaviness, and heard a far-off door slide open and the shuffling sounds of boots on linoleum. At the end of the hall he saw dim specters round the corner, grim-faced medics in helmets with huge tinted goggles and headsets still attached, one holding an IV bag aloft and squeezing it hard, a body on the stretcher between them. Their dark blue jumpsuits displayed the red and silver stripe of the Medivac team and scissors and syringes stuck out from their pockets. A large monitor rested on the thick metal stretcher with the patient, of whom Trevor could only see his dead looking feet.
“Is the trauma bay clear?” one of them asked calmly. Trevor turned and started walking briskly away, coming around the corner into the trauma area ahead of them. It was eerily still there and Trevor felt his heart kick up into his throat. He broke into a sprint and stopped outside the trauma bay. Although the room and equipment were intact it was devoid of people. He looked back out to the department to see a few nearby clerks milling about, a couple scribes silently typing, and some others off in his periphery. This happened sometimes on extremely busy nights: everyone of any consequence was engaged with a patient inside their respective rooms. He looked back to see the medics approaching and when they got near he asked
“What is this?”
“Motorcycle” the same medic said. The other one kept squeezing the bag as they swung into the room, staring at the monitor. Trevor glanced at it and saw a heart rate of 140 and a blood pressure of 95/50. The blood pressure was workable but the heart rate was ominous. The medics parked the patient next to the hospital stretcher and Trevor walked over to look at the patient as the medic kept talking.
“He said he was going about 60 miles an hour, his bike was found 100 yards down the road from him and he told the ground crew he bounced off the guardrail with his stomach.” Trevor locked eyes with the medic.
“Holy shit” he finally said. He quickly noted several things at once while the medic talked. The boys nailbeds on his toes were completely white, his lips were blue, but his eyes were open. Trevor snapped the button so the monitor would take the blood pressure again and turned to the red phone on the wall, just as the nurse in charge came in the room.
“Did you activate the trauma team?” he yelled as he dialed the surgeons’ pager.
“What?” she asked, coming over to the boy and looking him up and down.
“Did you order the blood?” he demanded.
“Get this patient on the stretcher” she told the medics, and turned around.
“Trevor I don’t know what you’re talking about, this boy is completely awake and the medics gave me normal vital signs.” Trevor glared at her while he typed the trauma code into the phone, which would bring a team of surgeons to the room within 2 minutes. He clicked the receiver furiously as the medics lifted the boy in his sheets onto the bed, and when he heard a dial tone he punched a few numbers. Trevor leaned over and put his finger on the top of the patients foot and couldn’t feel a pulse. He looked at his boss and said
“Send someone to the blood bank. Now” he added, as a voice came over the line,
“Blood bank”
“This is the ER. We need 4 uncrossmatched units of blood. Someone’s coming for them” He slammed the phone down and turned back to the boy. His new blood pressure was 60 on 40.
“Fuck. I knew it” he said, reaching across the room and grabbed the rapid infuser. At this point his boss had also leapt into action, helping the medic transfer the boy onto the portable cardiac monitor. They quickly cut off his clothes and heaped them onto the counter. Trevor stood near the boys head and looked at him while he assembled the monstrous, arachnid machine that was able to infuse 2 liters of fluid in under 5 minutes. He frantically slammed tubes into brackets and clicked levers open or shut. He looked to the patient.
“Hey man. Hey! You look good dude. What’s your name?” Slowly the wraith of a boy looked at him and said, thickly
“John.” At this point his boss was leaned over Johns left arm, putting in what Trevor knew was going to be a large bore IV. From his vantage point Trevor could see thick protruding veins, proud and swollen even in death. Only a man this young, Trevor thought, would be able to have his veins stand out and carry on a conversation as his life poured out rapidly into his pelvis, or abdomen, or wherever it was going.
“All right John, your job is to stay awake.” Even as he said this, he saw Johns eyes closing.
“John!” he yelled, and Johns eyes snapped open. “John, what kind of bike do you have? I ride’
“Oh yeah?” he said, his voice coming from far away. “Shit. I think my bikes prob’ly trashed.”
“Don’t worry about that now.” Trevor ripped open two bags of saline, hung them on the hook, and stabbed the spiked plastic tip into them, watching the fluid fill the wide tubes that snaked down the machine. He held the end and watched impatiently for the fluid to spew forth, and his boss stood with one hand on the newly inserted IV and the other outstretched waiting to take the catheter. As soon as the fluid appeared he thrust it into her hand and she twisted it onto the IV. Trevor turned to the machine and began to get it ready to rapidly infuse and he said, not looking,
“Did you send someone for the blood?” He heard something slam and he looked to see her hand on the counter as she glared at him. After a split second she turned and left the room, and he knew that although she was doing what he said, she was pissed he was bossing her around. Fuck her, he thought. She should’ve had this whole thing ready before they got here. He pushed each bag into their compartments, shut the hard plastic casing, and flipped the switch. Instantly, two thick rubber balloons inflated inside the closed chamber and smashed the bags of fluid up against the transparent wall. He and the two medics looked back to the patient, the one still holding and squeezing the almost empty bag into his other arm. Trevor grabbed a paper towel and pulled his pen quickly out of his pocket.
“John” he yelled. John opened his eyes, very slowly this time. “Stay awake buddy. Do you have any allergies to medication?” John just stared at him and slowly closed his eyes again.
“Fuck” Trevor said, and looked back at the machine. He swished the paper towel onto the ground and put his pen back in his pocket.
“His feet don’t have any pulses” one of the medics said.
“I know” Trevor said. “How was he in the chopper?”
“Awake the whole time, vitals not great but not so bad.”
“He must’ve crashed right as you were coming down the hall”
“Yep” the one squeezing the bag said.
“Did you give him any drugs?” The medic looked at him, the bag partially obscuring his face.
“No. His pressure was too soft.”
“Yeah” Trevor said. The kid was gonna die in pain, like so many traumas, because his fleeting blood pressure couldn’t withstand the relaxing effect of the narcotics. At times like this Trevor wanted to push epinephrine on living people, but he knew it would be totally futile. They stood silently and watched John take a few breaths. His body was very pale, and the first medic slapped him on the shoulder. “John! Wake up!” John opened his eyes, even slower this time, and looked eerily at Trevor and the medic.
“Hey buddy” the medic said, very quietly. Suddenly, three men and one woman in white coats came into the room and before they reached the patient Trevor said
“He has no pulses below the waist” and cringed inwardly, because he hadn’t thought to check for a popliteal or femoral pulse. Three of the doctors ignored him but one looked at him and spat
“What?” putting two fingers into Johns crotch, looking at Trevor and then the rapid infuser. “How many liters has he gotten?” Trevor looked to the two in the machine and the empty one the medic was taking down. Before he could answer, the first medic said
“Four.” So they had given him another one en route.
“What happened?” one of the doctors asked. Thus far the other three doctors hadn’t looked anywhere but at John. Usually they were calling things out to each other and searching for injuries, but here they were concerningly silent. The attending stood with his chin in his hand at Johns head and concentrated on Johns face, glancing quickly at the monitor and back, and the other two were scanning Johns exposed, dying body. As one of the other doctors, the female, was turning on the ultrasound machine and putting lubrication on Johns abdomen, the medic spoke up.
“Motorcycle, high rate of speed, hit a guardrail.” None of the doctors spoke as the one applied the ultrasound probe and looked at the screen, which was obscured by her body so only she could see it. After a few long seconds she announced
“Free fluid.”
Taking his hand off his chin, the head doctor said “Let’s go” and left the room. The other three doctors just stood there, but Trevor kicked the beds locking mechanism, pushed it forward with one hand and grabbed the rapid infuser with the other.
“Get the monitor” he said.
“Where’s the blood?” one of the doctors asked.
“On the way” Trevor said.
“Send it to the OR” the doc replied, and at once they all grabbed the stretcher and began hauling it away. Trevor let go and continued to push the wheeled infuser, which was probably almost empty by now. He turned it off and wished he could disconnect it and recheck a blood pressure. He followed behind, walking duck legged as he tried to make way for the trailing medic who held the monitor. Trevor wanted desperately to see the screen but he couldn’t get to it, however he was able to catch glimpses of John and could see he was still breathing. He could also see Johns protruding toes, which were now blue.
“Did his feet have any pulses?” one doc asked as they travelled.
“No” the other doctor responded.
They all came to the OR and stopped as the door slid open, then hurried in. Instantly the doctors all ran through another door and disappeared. Trevor quickly detached the IV tubing and looked at the monitor. Johns heart rate was still 140 but his BP was now 70 on 45. The fluid had bought a little time. He hadn’t noticed anybody else in the anteroom but somehow there was a sweating, bespectacled man with a thick mustache leaning into him.
“Where is the blood” he asked, looking about frantically.
“We got here first”
“Ahhh shit” the man said. “Where is the fluid?”
“Its all infused”
“How can you put fluid in without any blood?” The man yelled. “What size IVs do you have?”
“A 14 and a 16” the medic answered, and instantly Trevor knew the man was an anesthesiologist. Surgeons never ask that question. He looked at Trevor and then suddenly away, past him towards the door they heard opening. The doc slammed into him as they both turned and Trevor grabbed the stretcher to right himself, but the doctor never broke stride and Trevor saw him rip a cooler out of the hands of the approaching technician. He ran back and threw the cooler on the floor, opened it, and began running a bag of blood through the filtered tubing. He stood up and handed the bag to Trevor.
“Hold this.” He walked around with the tubing and as the blood began to pour out and spatter on the floor he screwed it onto the left IV, coating Johns arm in the cold red fluid.
“Hold that up high and squeeze it” he said as he prepared another bag. Just then a man in a paper jump suit wearing plastic goggles, paper booties, and a fluffy blue cap forced open the OR bay door and said
“we’re ready,” and disappeared down a wide, metallic hallway. The doctor threw the blood back in the cooler and shoved the cooler into the medics arm saying “Take this.” He grabbed the blood out of Trevor’s hand and pushed the stretcher into the OR. Trevor watched them go as the doors slid shut. He turned to the exit to see the tech had already gone back to the ER.