Chapter 2: Squad 51, P.I.
The dorm was silent, save the quiet noises of five people breathing in their sleep, and the sound of one person snoring gently. Henry, the station's basset hound, was curled up on a dog bed next to Chet's bunk. The dog had learned during his time at the station that the three different groups of men who inhabited his home each had one man who would tolerate or enjoy having Henry's dog bed near his bunk, and had taught himself the trick of moving his dog bed to be near the correct bunk shortly after shift change each morning.
Henry suddenly lifted his head, woken by a sound the men couldn't hear. He'd learned not to bark when the men were in their bunks, or he'd get banished to the day room, but he couldn't help making a slight "huff" when he heard the speaker of the PA system come on nearly silently, about five seconds before the tones sounded.
BWAMP, BWOOM BWEEEP! The dorm's lights came on, their harsh glare making Henry cover his eyes with a paw.
"Squad 51, unknown type rescue. 12488 Murphy Court. 12488 Murphy Court, cross street MacAllister. Time out: 0325."
Johnny and Roy stepped into their boots and bunker pants on autopilot. Roy fired up the squad, as Johnny acknowledged the call and then stepped into the squad, throwing his coat on as he did so.
"Man, that's number three already tonight," Johnny said, yawning. "And you know how I love the unknown type rescue."
"Mm," Roy said, not in the mood for a discussion of any kind, let alone a Gage special rant. Just because Johnny had the ability to be instantly awake and alert didn't mean that Roy had to appreciate the steady stream of verbiage.
"Maybe someone's kid was just playing with the phone, and we can just go back to the barn right away," Johnny said.
"Uh huh," Roy said, trying hard to show his disinterest in Johnny's speculations.
He wasn't getting through.
"Or maybe it'll be a party, and someone's really drunk, and their friends tried to—cross street's the next one—tried to call, but he hung the phone up on them—yeah, this is it. Should be the fourth block. Or maybe someone—"
"Johnny," Roy said, not taking his eyes off the road.
"What? Okay, here it is. Yeah, I've been to this block before, I think. These are some pretty swanky places, pal."
Roy just grunted as he got out the O2 and biophone and handed them to Johnny. He took the drug and trauma boxes himself, and closed the compartments of the squad. They trudged to the front door of the house. Johnny set down the O2, and banged forcefully on the door.
The door swung open at the first blow.
"Well, how 'bout that?" Johnny said. "Fire department!" he shouted into the foyer.
"All right, let's go in," Johnny said.
As they stepped into the house, they could immediately hear the sounds of labored breathing coming from the living room just off the foyer. They raced to a man who was seated at the edge of a couch, across from the fireplace in the modern and elegant room. He had his hands on knees, back straight, neck extended, and was working mightily to inhale some small quantity of air through what Johnny and Roy could already tell was a seriously inflamed airway. The man's face was red and swollen, and he had a rash on his exposed hands and lower arms.
Johnny set up the oxygen, and started his patter, as Roy called dispatch for an ambulance and began getting an initial set of vitals.
"Sir, we're paramedics from the fire department. I'm putting some oxygen on you, to help you breathe better. Can you talk at all?"
The man shook his head, but pointed to a piece of paper on the coffee table the paramedics had pushed aside. Roy began his initial report over the biophone, and Johnny tuned in with one ear as he picked up the sheet of paper.
He read it aloud. "Can't breathe. Itchy rash started 10 pm. Don't know why. Didn't eat anything weird or do anything unusual." He handed the note to Roy, who relayed it to Rampart and handed it back to Johnny.
Johnny looked up at the man. "Did it get worse fast?"
The man nodded.
"Is the oxygen helping you at all?"
The man grabbed the paper from Johnny, and jabbed his finger at the first two words: "Can't breathe."
"The air's just not getting in," Johnny clarified.
The man nodded, and his head drooped with the effort. He slumped over, no longer able to hold himself up in the position that seemed to help him breathe more easily. Johnny laid him out on the couch, and elevated his upper body with a stack of pillows so he could be more upright.
Roy repeated Rampart's instructions back over the biophone. "10-4, Rampart. Point three milligrams epinephrine, sub-q, IV D5W TKO, and then a new set of vitals."
Johnny grabbed the epinephrine and a syringe from the drug box, and Roy set up the IV.
"I'm going to give you a shot of epinephrine. That's a medicine that can sometimes help if someone's airway is swelling up like yours." He administered the medication. "Your heart might race, and you'll probably feel a little jittery; those are just normal side effects. My partner's getting an IV going for you because fluids can help, and in case we need to give you some more medicine in a hurry."
Their patient was beyond any ability to respond—all his energy was going in to trying to suck some modicum of air into his lungs. Johnny waited a minute or two until Roy had the IV going, and then listened to the patient's lung sounds again.
He shook his head. "I don't think the epi's helping." He reached into a bag, and took out an ambu-bag setup. He got it all put together, but waited until the last second to move the oxygen tubing from the non-rebreather to the ambu-bag setup.
"Here's what we're gonna do, sir," he explained, not sure whether the man could hear or not. "I'm gonna use the bag on this mask to help you get more air into your lungs. It'll feel a little strange, but it'll get more air into your lungs for you."
Johnny knew the man was past the point where he'd try to fight the ventilations, so he quickly plugged the O2 tubing into the port on the ambu-bag, pulled the non-rebreather mask off the patient's face, and replaced it with the ambu-bag mask. He began squeezing the bag, matching the rhythm with the patient's own efforts to breathe.
Roy was reporting the lack of effect of the epinephrine just as the ambulance attendants brought the stretcher in.
"Roy, we both need to ride in with this guy."
Roy nodded. One or other of them would be on the ambu-bag the entire time, and they'd likely need another set of hands if—or more likely, when—the patient continued his downwards trend. Roy and the two attendants loaded the patient onto the stretcher as Johnny continued with the bagging.
The ride to Rampart was tense—the patient was barely conscious, but not unconscious, so they couldn't intubate him. Even if he'd been unconscious, Johnny thought as he continued bagging the patient, the airway was probably so inflamed they wouldn't be able to pass the tube anyhow.
Roy took over other duties as Johnny manned the ambu-bag. He cut away the patient's clothing, just to make sure they hadn't missed anything. He frowned at the pattern of the rash. On each arm, the rash ended in a sharp line, right where a short-sleeved shirt would end. The patient's neck and face were red and swollen, but his chest and torso were clear.
"Not hives, then," Roy said. "Weird." He picked up the biophone and relayed the new information to Rampart.
"Rampart, Squad 51. The patient's rash is only on the face and neck and in areas of the upper body that would not be covered by a short-sleeved shirt. Lower body is clear. The pattern is like a sunburn, but the rash looks more like hives or blisters."
"Copy, 51," said Dr. Brackett's voice. Roy pictured the "W" shape that Brackett's eyebrows made when he was flummoxed. This was likely one of those times. "Continue bagging, no additional treatments at this time."
"You need to swap?" Roy asked Johnny.
Johnny shook his head, not looking up as he concentrated on timing his squeezes of the bag with the patient's own respiratory efforts. "I'm good. We're almost there anyhow, right?"
"Two minutes to the doors," Roy said.
"Good. Tell them I'm barely getting anything in, here." Johnny frowned as he concentrated on forcing air through the patient's swollen airway, each squeeze of the bag requiring more force.
Roy relayed the information to Rampart, and looked over at the patient's face as he heard a high-pitched squeaking sound on each squeeze of the bag.
"Roy, I need another set of hands on the mask. I can't keep the mask on tight enough with one hand, and the air's leaking out every time I squeeze."
Roy pushed in right next to Johnny, and pressed the patient's jaw and the mask together hard enough for the seal to override the pressure of the oxygen-rich air Johnny was sending from the bag.
Roy shouted up to the driver. "Bill? Gonna need to you open the doors, 'cause all our hands are busy back here."
The ambulance swooped under the raised second floor of the hospital, and backed into the slot by the ER doors. Bill hopped out and yanked the doors open. Dixie and two orderlies met the gurney at the ambulance doors.
"Treatment 2," said Dixie. "Kel's all set up for a trach."
"Not a second too soon," Johnny said. "He's exchanging next to nothing at this point."
The patient was unconscious, pale, and sweaty. His lips and fingertips were an alarming bluish color.
"Keep doing what you can," said Brackett. He and Dixie started the procedure, and quickly opened a hole below the man's larynx. Dixie attached the ventilator tube onto the end of the trach tube, and everyone stood back to see whether the ventilator would be able to do the job, or whether the lower airways were swollen shut too.
Everyone sighed in relief as the man's chest visibly rose and fell. He regained a healthier color—at least in the parts of his body that weren't covered with the blister-like rash.
As the patient's condition improved, the question of what had happened to him re-arose.
"He's clearly been exposed to something, and it looks like it was airborne," Kel said, almost to himself. "It got on any exposed skin, and he obviously inhaled it, too. But what?"
"He apparently didn't know himself," Johnny said, "from that note he wrote."
Brackett shook his head. "I don't like this," he said. "I'd normally sedate the hell out of him for a while, since it's no good letting patients wake up on a ventilator, but we have to get some more information from him."
As if the patient could hear him, he started stirring. His hands reached for the new pain in his throat, but Johnny quickly and gently restrained him.
"You're all right," Brackett said in a soothing tone. The patient's eyes darted back and forth wildly, and settled on Johnny—the most familiar of the group.
"You're at the hospital," Johnny said. "Try not to fight the breathing machine, okay?"
"Actually, I'll turn the ventilator off," said Dr. Brackett, "and just hook O2 up to the trach tube." He did so, and the patient seemed less panicked.
"I'm Dr. Brackett. Your airway—the tube that carries air to your lungs—swelled up so tightly you couldn't get any air through," Brackett explained. "I had to make a hole in your throat so you could get air in. Don't try to talk—just blink once for yes and twice for no. Do you understand?"
The man blinked once.
"Do you think you could write?"
The man blinked once, and Dixie handed him a pad and a pen.
"Don't know what happened," he scrawled.
"I know. We're going to try to get to the bottom of that, with a little detective work, so we can see about fixing the problem," Brackett answered. "What it looks like, was you were exposed to something through the air. It got on your skin sometime when you were wearing a short-sleeved shirt. You also breathed it in. It was almost certainly within the last twelve to eighteen hours. Can you write me a list of everywhere you've been during that time?"
"Just home," the man wrote. "Wife visiting mother. House to myself."
"All right," Brackett said. "Did you do anything unusual during that time?"
"Don't know," the man wrote.
"Were you outside at all?"
"Inside, the whole day?"
"Yes." The man frowned, and crossed out his "yes" as well as the preceding "no." "Went outside to do some chores. Nothing unusual."
"Did you mow the lawn?" Brackett asked.
"Use any chemicals—even ones you've used before?"
He pointed to his previous "no," and underlined "nothing unusual" on the line above.
"Did you do any cooking?"
"No. Helpless in kitchen. Frozen dinner."
Brackett frowned spectacularly. "All right. Here's what I'd like to do, with your permission. I'd like Gage and DeSoto—the two paramedics who helped you out and brought you in here—to go back to your house, and take a look around to see if they can figure anything out."
"Yes. Garage & shed keys on hook by back door."
"All right—go, boys. Call when you find something."
"Uh, Doc—we both came in on the ambulance," Roy pointed out. "And it's surely gone by now."
"You can take my car," Dixie said. "C'mon—I'll get you my keys."
They stopped at the nurses' station, and Dixie fished her keys out of her purse. "You know my car, right Johnny? It's about halfway towards the back of the employee lot, about in the middle."
"Tan Ford Maverick, right?"
"You got it."
"All right. We'll be back," Johnny said, as they trotted out to the parking lot.
Johnny drove, and Roy called in to dispatch on the HT.
"Dispatch, Squad 51. We've been directed by medical control to return to our last scene to look for a source of exposure. Requesting law enforcement to meet us there."
"10-4, Squad 51. Law enforcement en route."
They arrived back at the house just as the cruiser pulled up behind the squad.
"What do you have?" asked the deputy.
"Some kind of environmental exposure—the doc from Rampart wants us to look around. The patient gave permission, but, you know," Roy said uncomfortably.
"Yeah. Good to have a witness. All right—what are we looking for?"
"No idea," Johnny said. "Whatever it was got airborne somehow. Cleaning supplies, chemicals, anything. How about if one of us starts inside, and one person takes the shed, and the other the garage?"
"Sounds good," the deputy said. "I guess I'll take the garage—see what I can find."
"I'll take the shed," Johnny said.
"I'll poke around in the kitchen, first," said Roy. "And the bathroom."
They went their separate ways, each man thinking about every item they encountered. Johnny needed his flashlight to see anything in the shed. It was full of gardening supplies, but the man said he hadn't used any of them. He surveyed the yard, shining his light on each plant he encountered to see if there was anything unusual or poisonous. Nothing.
There was a neatly stacked wood pile under an extension of the roof of the shed. Johnny recalled the fireplace in the living room, and decided to take a closer look at the wood. He trotted back to the squad and pulled on a pair of leather gloves, and began unstacking the wood.
After picking up only three or four logs, Johnny found something. A hairy vine about three quarters of an inch thick snaked across one of the logs.
"Bingo," he said under his breath. He brought the log back into the house, and looked around the kitchen for a bag.
"Hey Roy?" he yelled, as he found a paper grocery bag, placing the log into the bag. "I think maybe I got it!"
He took his gloves off, placing them in the bag as well. He washed his hands thoroughly at the kitchen sink, and dried them on a towel. "Don't touch the bag," he cautioned, as Roy came into the kitchen. "I'll explain in a minute."
Johnny picked up the kitchen phone, and dialed Rampart. He was immediately put through to Dr. Brackett.
"Doc? I think I got it," Johnny said. "Ask him if he had a fire in his fireplace."
"He says he did, in the evening," Brackett said. "What did you find?"
"Poison ivy vines on the firewood."
Brackett sighed heavily into the phone. "That explains it," he said. "That has to be it. I'll start him on a course of steroids. Great work, Johnny. Great work."
"No problem, Doc. I'll bring in a log, just so you can be sure, but I think we cracked this case."
"Wide open," agreed Brackett. "See you shortly."
Roy went and fetched the deputy, who found the man's house keys, locked the house, and gave the keys to Roy. Johnny tossed the well-wrapped log in the back of the squad, and drove Dixie's car back to Rampart, with Roy leading in the squad.
Roy brought the log in to the emergency room, and showed it to Dr. Brackett, who was waiting at the nurses' station with a large textbook.
"That looks like a match, all right," Brackett said.
Roy looked over his shoulder, and noted the title on the top of each page: Toxicology. The picture of the vine certainly matched the log that Johnny had found.
"And we're on the right track, treatment wise. Steroids for inflammation, and supportive care as needed for ventilation and respiration. And right here, it says, 'cases with severe airway inflammation may require tracheotomy and artificial ventilation.'" Brackett lingered on the page for a few more seconds, and flipped the book shut, just as Johnny returned from reparking Dixie's car.
"How's he doing, Doc?" Johnny asked, setting the keys on the counter.
"Just fine, Johnny. He'll probably only need the trach for a day or so, and then he'll be fine. That was good work you two did today, first getting him in here alive and then finding the source of the problem. I have to admit, I was stumped," Brackett said.
"Us too, Doc, until Mr. Detective here found that log," said Roy.
"Well—good work, both of you. And, I'll be sure this log gets disposed of so it won't get touched or burned."
Johnny and Roy trudged back out to the squad.
"Squad 51, available and returning to quarters," Roy reported.
"Squad 51, copy."
"Well," Johnny said, as he buckled himself in, "as 'unknown type rescues' go, that one was pretty interesting. Got kind of hairy there in the ambulance, but it sounds like it's all going to turn out all right."
Roy looked at his watch at the stop sign by the parking lot exit. "We might even get an hour of shuteye, too."
"I could manage that," Johnny said.
Five minutes later, Roy backed the squad into the empty bay, and they were greeted by Henry. Roy checked the call log. "Engine's out at a structure fire with 8s."
"Bummer," said Johnny. "That'll probably take 'em past shift change."
They both washed up, trailed by Henry the entire way.
"C'mon, boy; back to bed," Johnny told the dog, as the three of them entered the empty dorm.
Henry whimpered at him, and looked at his dog bed, which looked forlorn and lonely next to Chet's empty bunk. He whimpered again.
"In your bed," Johnny said, pointing to the bed.
Henry put his head down, and walked over to his dog bed.
"Hey, Roy, look! Henry's doin' what I said! He's goin' to his bed, just like I told him to!"
"That's great," Roy said, his tone and his yawn expressing his disinterest. "Now you go to your bed."
Johnny stepped out of his pants and boots, and climbed into his bunk. He picked up his head when he heard a rustling from the other side of the room. He saw Henry grab his dog bed in his mouth, and drag it away from Chet's empty bunk. Johnny watched, mouth open, as Henry took his bed past Johnny's bunk, and dropped it on the floor at the foot of Roy's bunk. Henry looked at Johnny mournfully, climbed into his bed, circled a few times, and plopped himself down.
Johnny just shook his head. "And here I thought we were getting to be friends," he said. He closed his eyes, and was asleep instantly.