Basic Life Support

Sophia Emmons-Bell
Photograph by Mat Napo on Unsplash

The code to narcotics is 911. Or, 9111. Or, 9 and as many 1s as it takes. Our van-ambulances open with keypads and they’re all set to 9111111. Seven digits, like a phone number, and you’re in, with the candy-pink backboards, the curlicued oxygen tubes, the cold, textured metal floors. Three sizes of foam c-spine collars. Enough lidocaine to numb a horse. The ambulances have military grade GPS, though, so they’re not worth stealing. Dispatch always has the coordinates. They even know what parking spot you’re in. They call me sometimes: You’re on the wrong street, and I’m like, You gave me the address!

Only the pain meds are locked up. The important medications are easy to find. Narcan, epinephrine, D10, they’re at the front of the med pouch, in salmon boxes, in vials with bright red tops, in big watery pouches. It’s a good system. Quick in an emergency. Imagine someone’s coding and you’re opening a lockbox. Is it 911 or 9111? while he isn’t breathing.

I’m not doing anything exciting. I’m just showing the trainee, Ezra. He doesn’t know his way around the truck. He brings his own gloves because he can’t find the men’s mediums.

 

We’re parked by a funeral home called Chapel of the Chimes when dispatch calls about a domestic dispute. The Chapel is a large mausoleum, grand like an old Mission church, and takes up the whole block with off-white stucco and scalloped brick shingles. It’s beautiful. It’s where my mother is buried. Tonight, we’ve had a slow night. Just transports and traumas: broken wrists, hospital discharges, weepy psych transfers with their steely police chauffeurs. It’s 7 p.m., but already night has fallen and lights from our cabin illuminate the nearby sidewalk.

Over the radio, dispatch says trauma and then elaborates on the nonurgent channel. It’s two patients, maybe three, with fire and police responding alongside us.

“Here we go, Ezra,” I say.

“Go time,” my partner Lucas says from the jump seat. “Find your seat belt.” Lucas taunts because Ezra’s so eager. If we asked, Ezra would stick a plastic airway tube, lube and all, down his own nose.

“They said a trauma patient?” Ezra asks.

“A couple patients,” I say.

“That could be big, Ezra,” Lucas says. “Three providers, four patients? That’s a Mass Casualty.”

“If we’re first on scene you can be Incident Commander,” I say.

“Make a triage zone.”

“Ration supplies.”

“Big man in charge,” Lucas says.

Ezra’s twenty-five and already an EMT. He’s in paramedic school. He does ambulance ride-alongs with us because we let him say what he likes. After a call, in those untracked moments between leaving a patient in Emergency and signing back onto dispatch, we let him complain. About the back pain. The hours. The old patients, the belligerent ones, the heavy ones, the drunk ones, the frightened ones. It stops him from bottling it up. But only after a call. With patients, I run a tight ship. I had a mentor once, Jeremy, who was fired for saying too much, too thoughtlessly, so I keep an eye on Ezra. Let him say what he wants, but only on my watch.

Lucas straps the jump bag, oxygen tank, and trauma purse to the stretcher. He climbs into the passenger seat and leaves Ezra alone in the cabin, combing through the trauma purse to familiarize himself with its contents. Between calls I’ve been quizzing Ezra for his practical exam. I’ll make him feed a drop of his own blood into a glucometer. Shine a penlight into my eyes. Unsnap my tactical shirt and stick electrodes across my chest—smoke over fire, the black lead goes over the red, and all that. He’s done it all before but needs the practice. All you need is a steady hand for patients to believe you’re competent.

“Radio us in?” Lucas calls back to the cabin.

“Bay View, this is P-11 on channel 13,” Ezra says into his shoulder.

I pull lights and sirens onto Broadway. Hearing us, Oakland parts and makes way.

 

Sometime after my mother died, in the fluid-like weeks when I didn’t listen to music for fear I would push her memory away, my mentor Jeremy and I watched his daughter Esther have a grand mal seizure in my backyard. I was cleaning out my mother’s house. Jeremy was looking through a box of kids’ toys I’d found in the attic. He’d made a pile for Esther—a matted teddy bear, a few cardboard books. She was watching the neighbor’s dog chase a squirrel. The squirrel was darting between the large, flat leaves of the fig tree. She stood, walked toward the house, and then crouched down, lay on her back, and began to seize.

It was gentle. It lasted a long time. She seized softly, sweaty-faced, making suckling noises like an infant eating from a bottle. Jeremy sat with her, looking into her eyes like he was looking into the sun. Her limbs stiffened in quick pulses. Sweet, sweaty girl. As I watched them an ache built up behind my eyes, this aching wish that I could have held my mother like that as she died, could have cupped the back of her damp neck, held her little body, cast all my desperate love physically upon her.

The neighbor’s dog continued to bark and the squirrel dropped a ripe fig from the tree, splat. There was nothing to do but hold her until it passed. After a few minutes she started to take heavy, full-bellied, trancelike breaths, and her breaths were reassuringly loud and regular. We sat there, Esther’s head on Jeremy’s lap, until he drove her to the hospital.

Jeremy taught my paramedic course. He took it easy on me, which was uncharacteristic. Usually with him it was trial by fire. He was big and redfaced and harsh, always trying to toughen you up. He would shout his way through lectures, staccato like a drill sergeant, and raise a laughing ruckus if anyone fell asleep. Even while teaching, he spoke about patients with the antagonism of an enemy unit. We had simulation rooms with rubber patients that spoke, blinked their eyes, and bled, and through the patients he’d say, Can’t you see I have a needle in my arm? Or, I’m drunk. I’m choking on vomit. You’re not going to check my airway? Or, through the baby manikins, I don’t know my father’s face! I’m going to cry all night.

But he had a stoicism that resonated with me. This ability to hold tragedy at a distance, to look at massive injury and see only what needed to be done. That day as he took Esther in his arms and let her seize, watched her lovingly without calling for an ambulance or attempting any sort of intervention, I decided I’d forever imitate his stoicism.

 

As I turn onto MacArthur, dispatch tells me we’re only needed for backup materials. The other ambulances can handle the patients. From us they need a piece of equipment called an Israeli bandage, which is hemostatic gauze attached to an Ace bandage. There’s a head wound on scene and they’re out of gauze. All the army guys in our unit were excited when we started carrying the Israeli bandages because the clotting agent was developed for the battlefield. Jeremy found it funny because the army guys are old and out of shape now. He’d laugh when they would say In the field ... and then raise their ergonomic chairs to elbow height, drink Keurig coffee, eat pizza from the break room.

“New plan, Ezra,” I say. “They’ve got police and fire on scene. Lots of ALS. We’re playing backup,” I say.

“Your new job is to use that gauze,” Lucas says. “Got it?”

“Yeah, yeah,” he says.

Ezra’s annoyed he’s not seeing any action. His last service in Sacramento was all transports, all insurance requirements, so now he wants resuscitation, needle aspirations, Narcan-induced vomiting. I tell him to go be a trauma surgeon. I’ve been a paramedic five years and still do a few dozen transports a week. True, they’re boring, but they can be lovely. Like earlier today, when we took a ninety-year-old man from an assisted living facility to his daughter’s home in Alameda. It was one of those calls where you just take vitals and make conversation. Ezra was in the back, and Lucas and I were driving through light rain. It was pretty quiet. And then the man started singing loud church hymns, with this brilliant round voice that reverberated through the cabin, while Ezra was still listening to his lungs. Loud singing, right into Ezra’s stethoscope! Ezra yanked the stethoscope from his ears and yelped. Nearly knocked the mounted suction device off the wall. The singing was still going when we pulled up to the patient’s daughter’s house. We opened the ambulance doors to it, like we were at a Broadway show that had started before the curtains came up.

I turn the sirens off but leave the emergency lights on. Every few blocks there’s a streetlight and the pattern of our lights against the sidewalk reminds me of sheet music, how a melody is divided into measures. Four beats in the streetlights, four beats in the dark. We pass the evening traffic. We listen to calls over the radio: a two-year-old’s allergic reaction, a motorcycle accident with a complex tibia/fibula fracture. Monotone hospital reports. In the back, Ezra plays music on his phone.

In these quiet moments I wonder what Jeremy would make of Ezra. Lucas and I, we tease, but I think Jeremy would lay into him. Mock his sentimentality. Critique his shaky confidence. But now, I’m not sure. Jeremy was fired because he was caught on tape yelling obscenities at a patient’s caretaker. The family got it on video and threatened to sue. They agreed to settle out of court as long as Jeremy lost his job and his paramedic’s license. Still to this day, he thinks he was justified. He’d found the patient slouched in her wheelchair, barely conscious, sitting in her own soiled diaper. She’d been unattended for hours. She was an old woman. The caretaker was her niece. I’ve seen the video—he yelled so loud that both women started crying. It happened in the weeks after his daughter seized. The weeks after my mother died. Remembering his face when he held Esther, that steely tenderness, I know he would have been capable of anything.

 

On scene I park behind a line of emergency vehicles flashing red-white lights. Our vehicles take up half the block like the valeted cars of opera-goers. We’re on International, at the only multi-level apartment building in sight. Around us are boxy, stucco houses. Pedestrians step around medical cargo, climb into houses, and we all vibrate when a BART train passes beneath us.

“Apartment 301?” I ask a police officer leaning against his car.

“Two apartments,” he says, “301 and 304. It’s two brothers living next door to each other.” He gestures toward the apartment with a gloved hand.

“They’re both patients?” I ask.

“Yeah,” he says. “The mother’s there too. She’s freaking out.”

I open the apartment’s heavy door and let Ezra carry our equipment upstairs. His shoulders are both saddled by jump bags, his hands gloved. I appreciate the eagerness when it’s channeled in this manner—obsessive note taking, three sets of vitals, carrying the heaviest equipment. The oxygen tank key rattles against its metal canister as Ezra takes the stairs, two by two, toward our patients.

The third-floor hallway is filled with uniformed men. Firefighters are clumped by the stair landing, guarding heavy equipment, and police officers are walking randomly down the hallway. The floor is littered with reflective equipment bags, plasticky gauze wrappers, rolls of tape. It’s a beautiful building. Dark wooden paneling and crown molding, the style of my mother’s old house.

The doors to apartments 301 and 304 are at the end of the hallway, propped open by two police officers in crisp uniforms. In each apartment is a patient; the brothers have been separated for treatment and interrogation. There are shards of porcelain sprinkled like sand in the doorway of 301. Inside, I hear a bored paramedic asking about head pain. Inside 304, I only hear loud police officers.

We carry our equipment down the hallway. I knock on each door to catch the paramedics’ attention and offer the Israeli bandage, but the paramedics shrug at me. Neither patient seems critical, or even bleeding. The apartments have mirrored layouts, hallway on the left in 301 and the right in 304 and so on, but are similarly decorated. Vibrant wall hangings, dried flowers, pillowy couches. The brothers, too, are mirrored: one tall, lanky, and loud; one short, big, and gloomy. Ezra throws the trauma purse with our equipment down outside 301, anyways.

We lean against the wall next to a group of paramedics, which reminds me of smoking outside a party. I’m always amazed at how relaxed emergencies can be. Once the scene is secured it’s all muscle memory and checklists. Put your gloves on, take a patient history, conduct your physical exam. Ask the SAMPLE questions: Signs and symptoms? Allergies? And so on. And as the adage goes, everyone stops bleeding, eventually.

“What’s going on?” I ask one of them.

“They’re brothers,” he says. “Got into a fight. They were throwing dishes at each other all night until the mother called the cops.”

“You know what they were fighting about?”

“Mm-mm.”

“The big guy keeps talking about I need to talk to Marta,” a police officer says.

“Marta!”

“Anyone hit?” Ezra asks.

“One took a plate to the head,” the paramedic says. “The other’s hands are all cut up.”

“Ezra, plate to the head,” Lucas says. “That head wound’s for you.”

“Who’s this?”

“Ezra,” I say. “Paramedic school. Riding with us this month.”

“What’s up,” Ezra says.

There’s a crashing sound from 301, like porcelain falling into glass. The uniformed men just look at each other, trying to delegate the duty of going into the apartment and leaving their conversations. There’s a thick social laziness in the hallway, a casual energy we’re all reluctant to break. Inside 301 the patient is complaining loudly, and the paramedics are talking even louder. Finally, a young police officer peels off the wall and goes into the room. He emerges soon after, pushing the patient by the shoulder back into the hallway. The man looks mid-thirties, roughed up a bit and angry, taller than the rest of us. He throws the police officer’s hand off his shoulder but is woozy on his feet, bleeding from a reddened gash on his forehead. He’s carrying an ECG machine to which his bare chest is connected by twelve spindly, insulated wires. The paramedic from 301 follows and sits him down against the wall.

“Hold this,” the paramedic says, squatting to press gauze against his patient’s head. The man’s chest gleams dewy in the hallway.

“When did your rig get here?” I ask a firefighter.

“Ten, fifteen minutes? Dispatch said the mother was freaking out about glass, glass, broken glass. But it’s not glass. It’s just pieces of that plate.”

“Where is she?” Ezra asks.

The men point down the hallway to a woman sitting on the landing, feet draped down the spiral staircase. She’s hunched over, wrapped in a wool blanket, breathing quickly into her clasped palms. A few police officers are standing nearby, talking amongst themselves, all interest in questioning the woman lost.

I look back to the patient, now holding gauze to his own head. He seems bored, or at least bored of being angry, and is mumbling to himself. He readjusts his grip on the gauze and rubs his shoulder with his free hand. The paramedic prints out an ECG rhythm and stuffs it, unread, into his pocket. An uninflated blood pressure cuff dangles around the patient’s wrist, weighed down by the heavy calibration tool. The firefighters prowl like impatient dogs.

“Let’s go, Ezra,” I say. “Get the Israeli bandage so he doesn’t have to hold pressure himself anymore.”

“Your time to shine,” Lucas says.

Ezra unwraps the Israeli bandage and walks towards the patient. With his tall posture, fresh gloves, I’m glad he can participate in this call. Ezra towers over the patient, considering the locking mechanism of the Ace bandage. He threads the bandage into the buckle but can’t work out how tension is held, how to lock it in place. He dabs at the laceration with saline and gauze, then holds the Ace bandage up to the man’s head in a few configurations like he’s deciding where to hang a painting. He makes one attempt to secure the bandage, then stands, offers the patient his gloved hand to shake, and gives the bandage to the paramedic.

Me, Lucas, the paramedic, the firefighters, we all laugh at him.

“Big EMT!”

At the end of the hallway, draped over the stairs, the mother begins to wail.

 

It’s not that they look alike, but some days all women of a certain age or maternal atmosphere remind me of my mother. I can’t control it. Neither can I control the flash-like associations that bring me back to her. In an instant I’ll think I have leftovers, Mom loves this recipe, I should call her, I can’t call her. I can’t call her.

She died suddenly, two years ago, a rainy El Niño October. I was considering a house in Alameda and a promotion to the fire department. I sent her photos of every house I toured, and each time she would respond with a yellow thumbs-up emoji. I was working a lot. I didn’t know she was sick. I did know that she didn’t manage her glucose or blood pressure, so when the neighbors called I felt suddenly that I should have known, that I should have anticipated it, that I should have been the one to prevent it. They found her lying in her bed, shoes on.

The months that followed were ones of excavation. I dug through her house, cleaning, recycling, folding, giving away, finding very little to treasure, throwing away even what I treasured, donating ruthlessly so everything was placed. It was her body I wasn’t sure what to do with. Eventually, I had her cremated and placed in the Chapel of the Chimes. For years she’d lived blocks from the Chapel, and every summer solstice, when the Chapel hosted its memorial concert and filled its halls with jazz and a cappella, she would wander through, put me on speakerphone, and tell me about the dried flowers hung throughout the crypts. Now, I park nearby whenever we’re on call in Oakland. All the music inside, I think it’s her.

 

Everyone vacates the scene around the same time, leaving the hallway harsh-lighted and trash-littered. Both brothers will be taken to Highland Hospital, transported separately but reunited in Emergency. I hope we’re called to Highland later tonight; I want to see the brothers’ shouting reunion. The shattered plates are still on the hallway floor. Our trauma purse has been picked over. Most of the gauze and saline wash is gone. Outside, sirens whine away.

A firefighter uses a big landlord keyring to lock up 301 but can’t find the key for 304. He tries each key, one by one, and then gives up. He slams the door, leaving the apartment’s mess unprotected. Ezra pouts down the hallway, collecting trash into a red medical waste bag.

As the firefighters go downstairs the mother rouses and walks unsteadily towards us.

“Where did they go?” She gestures down the hall.

She’s wearing a bright red blouse and loose tan pants, with her blanket dragging behind her. She looks around, surveying the empty, dirty hallway. Both of her sons are gone.

“The hospital,” I say. “Highland.”

“Or wherever they asked to be taken. They were bleeding,” Lucas says.

She starts to cry softly into her shoulder, into the scratchy woolen blanket. “I don’t know where that is.”

She walks down the hallway speaking quiet Spanish and tries to open the door to 301. It’s locked. As she turns around I can see rusty blood staining the front of her pants, like she’s just wiped her hands after dinner. She is ignored by the firefighters, who sidestep her with as wide a berth as the hallway allows. I have an instinct to ignore her as well. There’s nobody on scene who would notice.

But I consider what will happen when we leave, when the hallway is completely stripped of its reflective bags and spiderweb gauze and uniformed men. I think of her sitting against the door to 301, waiting for hours for her sons to return from the hospital. At least one needs stitches. Probably a CAT scan. And then whatever paperwork the police have. I imagine her blanket wrapped more tightly around her shoulders, blood drying and flaking off her hands.

“We can take you,” I say. “Come in our ambulance. We’ll bring you to the hospital.”

She looks towards Ezra, who shrugs.

“We’ll bring you to your sons,” Lucas says.

I’m calling dispatch—Bay View, this is P-11, can you take us offline?—before she even answers.

“Don’t start a Patient Care Report,” I say to Ezra as he climbs into the ambulance’s cabin with the woman. “We’re not treating her. It’s just a ride.” This way she won’t get a bill and we won’t have to chart. We strap her into the jump seat, where Lucas sits when he’s treating a patient. It faces the stretcher and the ambulance’s doors. Ezra sits, unbuckled, on the cabin’s padded bench. The woman crosses her legs at the ankles.

“But get her some gauze,” I say as I close the cabin door. “Her hands are all bloody.”

 

For blocks there’s no noise from the back. We sit in chilly silence as we move through traffic. I turn down my radio chatter in case someone on the medic channel calls about the brothers. I’m not sure if the woman is listening but if her sons deteriorate I don’t want her to hear it from channel 13.

I start to think about the brothers. I wonder how often they argue. I wonder which has the upper hand in a fight, the big guy with his weight or the tall guy with his leverage. I wonder who Marta is. I wonder if the mother lives in 301 or 304, or if she’s visiting and her presence prompted the disagreement. I wonder if the blanket is hers.

As I pull onto the highway Ezra shouts, “Oh fuck! She passed out!”

“Passed out?” Lucas and I shuffle around in the front, surprised. Lucas unbuckles and pivots in his seat, but while we’re moving there’s no way for him to get to the back. I adjust my rearview mirror. Ezra is kneeling next to the jump seat, where the woman is slouched against the seatbelt, head lolling about. Ezra jostles her shoulder. He stands and circles the cabin, opening the aluminum-paneled cabinets, and I hear a thump like he’s pulled out a bag.

“Sit down, Ezra,” I say. “Buckle up. What are you looking for?”

He unzips whatever’s on his lap. The truck’s highway inertia swings him and the bag about. I hear a seatbelt unclick. Changing lanes, I can only see Ezra’s towering body.

“Put all that away. You’re not treating her.” If he charts syncopal episode and we don’t do everything right we’ll get called into chart review for sure. We could be fired. We’d need timestamps and vitals and insurance numbers. They’d read whatever PCR Ezra comes up with like, You put her in the jump seat?

“Don’t touch her,” I say.

There’s a bit more rustling, and then Ezra says, “She’s back.” I hear animated Spanish coming from the cabin, like it’s coming from behind a confessional screen. “Okay she’s back. Her eyes are open.”

“Keep her talking,” Lucas says. “Keep her airway open.”

“She’s, man, she’s freaking out,” Ezra says. “I don’t speak Spanish.”

“She can speak English,” I say. “We were talking to her earlier.”

“Ask her to count,” Lucas says. “Ask her what her sons’ names are. Ask her what they were fighting about.”

“Just keep her awake,” I say. “Tell her we’re almost to the hospital.” I remember the woman’s body curled into herself, small and compact among the uniformed men. I want Ezra to tuck her tightly into her wool blanket.

“Okay, I’ve got it. She’s fine,” Ezra says. “I’ve got it.” I glance behind and he’s strapped himself back onto the bench. The woman’s fast speech has lowered to a sweet hum.

“She’s awake? Alert?”

“She’s fine,” he says.

“Ezra, I almost pulled onto the shoulder,” I say.

“Don’t pull that shit again,” Lucas says. “Put all that equipment away. You’ll freak her out.”

“Is she okay or do you need us to come back there?” I ask.

“She’s good,” Ezra says.

“Okay,” I say. It calms me to hear soft voices from the back, the comfort of loosely overhearing a family conversation from another room.

I clap Lucas on the shoulder. “Fuck!” I say, and he laughs.

 

After a while we pull into the Highland Emergency bay. There are two ambulances parked back-in, their cabins facing Emergency. One crew is unloading a stretcher with a large woman lying on a crisp white sheet. A few paramedics are circled behind the other ambulance, passing around a vape pen.

I hop out and circle to Lucas’s side. “Tell dispatch we need a minute to get her inside?” he says.

“P-11,” I say into my radio, and then I open the cabin door to find Ezra kneeling in front of the jump seat.

A coil of oxygen tubing, ECG wires—I’m confused. I expected to see Ezra sitting on the bench, to see the woman wrapped meekly in her seatbelt, to see everything the way I’d left it when I closed the ambulance doors on International. But here is Ezra kneeling besides the woman. He’s loudly removing a blood pressure cuff from her arm. He has placed the ECG and medical bag on the stretcher. Pouches of IV fluid spill towards the floor. The ECG’s LED screen flickers like a car radio.

“What the fuck?” I say.

He stands up, and I can see the woman more clearly. She is sitting on the jump seat, breathing into an oxygen mask. Her red blouse is open like a jacket, exposing sections of her bare breasts to the cold ambulance bay.

With the back of his gloved hand, Ezra pushes her left breast up to attach an ECG sticker. The breast falls back down, covering the electrode.

“What’s going on?” Lucas says. “Did she faint again?”

“No,” Ezra says. He tears out a page from his pocket-sized notebook. “But I got a full set of vitals, and an IV line for the doctors.”

“She doesn’t need any of this!” Lucas says.

It’s all I can do to look away. The woman’s nodding head, her clammy skin, the chilly evening air. The flashing lights leaking into the cabin. The sounds of mechanized doors opening and shutting. The opaque electrode stickers disappearing below her breast. I stand with my calves against the metal lip of the ambulance and feel the cold metal through my tactical pants. I feel the chilly air through my collar. I hear her breathe wheezy and pitchy through the oxygen tank and think of Chapel of the Chimes.

I first went to the memorial concert ten months after my mother died. I didn’t want to visit her ashes. I wanted to hear the music. I knew that in each section of the chapel was a genre of music—jazz in the courtyard, experimental music in the foyer—and that my mother’s favorite had been a circular hymnal chant. I found the choir on the main floor, a circle of ten or twelve, producing a soft collective hum. They sounded like a full orchestra tuning before a show. Closer, I could tell that each member was singing, aahing, a different note. The room was insulated by high stone walls carved with diamond shapes. Each member had one hand on their heart, the other on their neighbor’s back. I walked up to the circle. I placed my hand on the back of an old man, a foot taller than me. I placed my other hand on my heart. I felt a neighbor’s hand on my back. I closed my eyes. Softly, aahing, I started to wail.

“Goddamn it, Ezra, cover that woman up,” I say, loudly. I jump into the cabin and pull her wool blanket up to her neck. Her legs are still crossed at the ankles. The condensation inside her oxygen mask is outlined with each of her deep breaths. I apologize over and over but she appears to be unbothered by the tubes, the nakedness, the busyness. She reaches to clasp Ezra’s hand before I push him out of the truck, into the wailing Emergency bay. He trips over the metal lip.

I realize that she’s still hooked up to the ECG. She still has a blood pressure cuff on. I pull the blanket down and softly peel the stickers from her clammy chest. I push her breast up to pull off the last sticker. I undo the blood pressure cuff’s loud Velcro. Small goosebumps, fine hair across her body. I tuck spare linens around her legs and pull them up to her armpits. She smiles out of the ambulance.

“Are you okay?” I say.

“Yes, yes,” she says. “I’m okay.”

“I’m so sorry. We’ll get you dressed,” I say.

“That’s okay,” she says.

Lucas and I unload her from the truck. The mechanical gurney holds the stretcher suspended over the Emergency bay and then gently lowers her to the ground. I wheel her inside. She clutches the crisp white sheets into Emergency. At the intake desk I prop her up and help her step off the gurney. She looks around the busy room. I gesture inside, toward Emergency. In there, probably, are her sons

There’s a cool draft in Emergency that follows me into the ambulance bay. Lucas, Ezra, and I lean against our truck and silently pass around a vape pen. Paramedics slip between the mechanized Emergency doors, disposing medical waste, replacing soiled linens. After a while the other ambulances peel away and it’s just the three of us, vaping in silence, until Lucas calls dispatch to put us back online.

Sophia Emmons-Bell is an MFA candidate at the Michener Center for Writers. She is from Berkeley, California. Her work has appeared in the Kenyon Review and the Harvard Advocate.

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