Not Responsible

by Carol D

John Gage glanced at his watch as he cruised down the street, his damp hair blowing in the wind from the open driver’s side window. Whaddya know, I’m actually ahead of schedule today. I could stop at that new donut shop and pick up a dozen. Wouldn’t the guys be shocked? Hell, they deserve it. That’s what I’ll do.

He peered at the speedometer and noticed he was going five miles per hour over the limit. He wasn’t concerned, noticing that several cars were passing him in the lefthand lane. As long as they’re speeding worse than I am, the cops’ll never notice me.

The traffic was actually light for a change. Johnny reached forward to change the radio station, keeping one eye on the road ahead. He was vaguely aware of a vehicle overtaking him in the lane to his left. He punched button after button, searching for some good driving music, but all he could find were commercials.

Pulling up to the next stoplight, Johnny unbuckled his seat belt and reached around to the floor behind his seat, grabbing his container of music tapes. He quickly selected one and inserted it into the player as the light changed to green. Johnny looked both ways before proceeding, a precautionary habit he’d developed driving the squad.

The truck to his left stayed even with him as he accelerated. Reaching his top gear, Johnny stretched his right arm across the seat back and tapped his fingers in time to the music. Lost in the song and relaxed, one hand on the wheel, his reaction time was no doubt compromised when the beige sedan eased into the lane in front of him.

Johnny’s right hand flew to the wheel and his foot stomped the brake pedal. The truck beside him left him nowhere to go. The Rover fishtailed in a cloud of smoke left by the burning tires. As his vehicle bore down on the small car, Johnny caught a clear picture of the elderly man behind the wheel, his shoulders stooped with age, his weathered fedora perched on his head. He never saw me!

Johnny braced for the impact but the jolt thrust his upper body into the steering wheel and his hands flew off to the sides from the force of the collision. He heard the sound of glass shattering and felt the sting of the tiny missiles as they sprayed his face and arms. His knee impacted sharply with the dashboard. And then, everything in reverse: his body rebounded, whipping his head back painfully, his arms slammed into the seat back and came to a rest at his sides. The radiator’s hiss rang in Johnny’s ears.

*****

“You guys have a good shift?” Roy asked the medics of C-shift as he poured himself a cup of coffee.

“Not too bad,” Charlie Dwyer replied.

“We actually got some sleep last night,” Glen, his partner, added.

“Yeah, after running back-to-back calls all afternoon yesterday.”

“Hey, I’d rather run ‘em in the afternoon than all night long,” Glen said.

“You got a point there, ”Charlie said. “Speaking of all night long, you’d better get used to getting no sleep, partner. When’s Sharon due again?”

“Six months,” Glen answered proudly. “In fact, we got an appointment at the obstetrician as soon as I get off.” He glanced at his watch. “He thinks we might hear the baby’s heartbeat today.“ The young man’s face glowed in anticipation.

“That’s great,” Roy said. “I remember when we first heard Chris’s heartbeat. It’s an amazing moment.”

Glen glanced at his watch again. “Come on, eight o’clock! I gotta get out of here on time!”

At that moment, the klaxons sounded. Glen slapped the table in frustration.

Station 51, Motor vehicle accident. Blake Boulevard just east of 11 th Street. Blake Boulevard just east of 11th Street. Ambulance has been dispatched. Time out, 7:48.

“Hey, Glen. I’ll take that call for you,” Roy offered.

“Would you?” Glen’s faced showed his relief. “Man, that would be great, Roy!”

“No problem. Take care of your family.” Roy slapped the other man’s shoulder as he walked briskly toward the bay. Roy passed by the newly arrived Hank Stanley on his way to the squad. “Cap, I’m taking this call for Glen. He’s gotta go to an appointment with his wife.”

Hank nodded. “Okay, Pal. I’ll let Johnny know when he gets here.”

The squad and engine careened out of the station, lights ablaze and sirens wailing.

*****

“Hey, you okay?”

Johnny turned his head slowly to the sound of the voice. A stranger stood just outside his window, staring at him, concern etched on his face.

“You okay, man?” he repeated.

“Yeah. Yeah, I’m okay.” Johnny’s own voice sounded like that of a stranger. Suddenly, the memory of the old man came rushing back to him. He tried to look out the front window, but the mangled hood and spare tire were all he could see. “I gotta get out of here!” Johnny grasped the door handle and tried in vain to release himself from the wrecked car. The door was jammed.

“Get me out of here!” he suddenly demanded of the startled stranger outside.

“Relax, man! You’re safe, there’s no fire or anything. Just be still until help gets here!”

“No, no. You don’t understand. I need...I need to get out. I need to check on the victim.” Johnny continued to slam his shoulder into the door in an effort to dislodge it. It didn’t budge.

“Hey, stop doing that! You’re gonna hurt yourself!”

Johnny glared at the other man. “Look,” he said in a low tone. “If you’re not gonna help me, get out of the way.”

The man, alarmed by the menacing tone of Johnny’s warning, stepped aside.

Johnny twisted himself in his seat so his feet pointed to the door. He braced himself, then drew his legs up and kicked as hard as he could, causing the door to pop open an inch. He drew back and kicked once more and the door opened halfway, protesting with a loud creak. Johnny clambered from the Rover and rushed to the sedan where a crowd had already gathered.

“Let me through!” he yelled, pushing his way past the gawkers.

“Hey, hey!”

Two hands were suddenly planted on Johnny’s chest, halting his movement. “Get off me!” Johnny snarled.

“No, just stay back!” A husky man wearing a jogging suit was doing everything he could to stay between the paramedic and the old man in the car.

“You don’t understand,” Johnny said breathlessly. “I’m an L.A. County paramedic. He needs medical attention, now! Let me through.” Johnny coughed dryly. “Please.” Sirens could be heard in the background.

“And I’m an off-duty police officer.” The man hesitated, looked into the car, then looked at Johnny again. He saw the desperation in the dark-haired man’s eyes. “Look...”

For the first time, Johnny looked into the face of the officer.

“I don’t think there’s any hope,” the man said quietly.

“Let me be the judge of that.” Johnny, his face bloodied from a multitude of tiny cuts, looked at the man beseechingly. He coughed again weakly, his eyes watering from the pain it caused.

A hint of doubt was enough to make the officer waver. This guy was a paramedic. Maybe he himself hadn’t really assessed the victim carefully enough. He didn’t have medical training, after all. “Okay. Go on,“ he acquiesced.

Just as Johnny was about to crawl into the passenger side of the old man’s car, Station 51 arrived on scene.

“Would you look at that...” Dwyer commented, steering the squad to a spot beside the scene. He and Roy realized the same thing at the same time.

Roy bolted from the side door before the truck came to a full stop. He ran first to the Land Rover but stopped quickly on noticing the door was open and it was apparently empty.

“Johnny!”

“He’s over there,” a bystander said, pointing to the other side of the wreckage. “The driver went over there.”

Charlie had already gone to the sedan while the engine crew quickly assessed the scene for hazardous fuel leaks.

“I need everybody to get back,” Hookrader ordered the small crowd that had gathered.

“Johnny, hey,” Dwyer called to his colleague in the car. “Why don’t you come on out of there and let us work.”

Johnny backed out of the car and stood unsteadily. “We need to get him out of there now. Rapid extrication. Backboard, c-collar. Hurry,” he said weakly, trying without success to stifle another round of coughing.

Charlie tried not to show his shock at Gage’s appearance. Little cuts peppered his face, and a stream of blood flowed from his nose. He stood slightly hunched over, his face ashen.

“Okay, Johnny. That’s good, we’ll take care of it,” Charlie said calmly. He looked around for someone to pass Gage off to. That was when Roy showed up. “Roy, you want to check your partner out here?” Charlie tried to steer Johnny towards his partner.

“No. No.” Johnny shook his head and held up his hand. “Roy, you help Charlie with the victim.”

Roy took one look at Johnny and knew instantly he was as much a victim as anyone. Still, he knew his partner well enough to realize that denial was very much at play. He would have to handle the situation carefully.

“Sure, Johnny. I’ll help Charlie out if you’ll go sit on the bumper and wait for me.”

“But Roy--”

“Johnny,” Roy said firmly, but softly, so as not to embarrass his friend. “I don’t have time to argue with you. We’ve got plenty of hands here. You need to sit down.”

“I’m fine, Roy.” Even as he insisted he was okay, Johnny grabbed the door with a shaky hand to steady himself. He put his fist to his chest when another dry cough shook his body.

“Gage!” Captain Hookrader had overheard the exchange. “Go sit on the bumper like your partner told you to. That’s an order.”

As the rest of the crew crowded in to help with the old man, Johnny limped over to the engine. He grimaced as he sat down gingerly. He began to notice that he didn’t feel right. His fingers tingled and he didn’t feel as if he could take a deep enough breath. Johnny tried to sit up straighter but it hurt his chest. He leaned forward, elbows on his knees, and propped his head in his hands. Only problem was, he couldn’t feel his head because his fingers were going numb. And, leaning over made it even harder to breathe. Johnny sat up again and his chest ached heavily. A new series of coughs overtook him and he was powerless to halt the painful hacks. He raised his hand to his sternum instinctively to brace it, noticing that anything more than a light touch was painful.

Johnny blinked rapidly and looked around. He was experiencing waves of dizziness and he’d broken out in a cold sweat. He could feel the rivulets run down his chest. I’ve gotta hold it together-- that old man needs all their help. Johnny knew he was close to passing out. He had about decided to try lying down when the decision was made for him. As a gray haze encroached on the periphery of his vision, a strange roar filled his head and suddenly the pain went away.

*****

Charlie finished examining the victim and turned to Roy, shaking his head sadly. “The impact was just too great and he’s just too old.”

Roy nodded and backed away from the car door so Charlie could get out.

“Code F, Cap,”Charlie reported. “Could someone get a blanket and cover him up?”

“I’m gonna check on Johnny,” Roy said. Just as he looked in the direction of the engine, he saw his partner pitch forward from his perch on the bumper. A stranger in a jogging suit caught Johnny and eased him to the ground before he could fall and injure himself further. “Charlie, bring the drug box and biophone!” Roy said before he ran to Johnny’s side.

*****

Dean, the off-duty police officer, had backed off once the fire department arrived. He continued to shoo the curious back away from the accident while keeping a watchful eye on the proceedings. Two police cruisers arrived simultaneously at the scene to begin their investigation. Dean introduced himself to the officers and explained what had occurred, pointing to Johnny as the driver of one of the vehicles, then let them continue with their official duties. He had seen one of the blue-shirted paramedics quietly confront the dark haired guy and the captain point to the fire engine. The off duty medic then limped resignedly over to the engine and sat down,obviously in pain. I don’t like the way he looks. He’s gone downhill fast since the accident happened.

Dean saw one of the uniformed officers walk towards Gage, notebook in hand, to take his statement. Dean trotted over to meet them and lend support, if necessary. He wanted the report to reflect the injured man’s attempts to help the second victim.

As he became even with the engine’s bumper, Dean saw the man sway and then fall forward. He was able to get between the unconscious man and the pavement just in time to prevent a headfirst fall onto the street. Dean eased Johnny to the ground, laying him carefully onto his back. He was about to call for help when he saw the paramedic from earlier rushing over, followed by a second one lugging equipment.

*****

Roy quickly knelt. “Johnny! Johnny, open your eyes for me!” He shook his partner’s arm but got no response. Roy applied his knuckles to Johnny’s sternum but, to his dismay, felt the bone “give” and immediately stopped. The action had the desired effect, however; Johnny moaned and thrashed, slowly regaining consciousness.

“He’s got crepitus in his sternum,” Roy said to Charlie, who was setting up the biophone.

Johnny blinked awake and looked around, surprised to find himself flat on the ground, and even more surprised to find Roy bent over him, in his uniform. Johnny wondered if he had on his uniform, if he’d been injured during a rescue. He licked his blood-caked lips and spoke. “Roy?” It was barely more than a whisper. The action of speaking set off a round of weak coughs. The dark haired man groaned in distress.

“It’s okay, Johnny. You’re gonna be fine,”his partner assured him as he pumped up the blood pressure cuff. Charlie came at him from the other side, preparing to affix an oxygen mask to his face. “Can you tell me where you hurt?”

Everywhere, Johnny thought. “My—“ he started to say, but was stopped by a spasm of pain. A small whimper escaped his lips and his face contorted in pain. He struggled to suppress another cough.

“What is it? What hurts?”Roy demanded.

“M-my chest h-hurts.” Johnny raised his hand to his chest and Roy noticed his thumb was swollen and discolored.

“Did you lose consciousness at all?”

Johnny shook his head slightly. “No.”

“Okay, partner. Take it easy.”Roy gently eased Gage’s hand away from his chest while Charlie prepared to slit open his shirt. The high flow of oxygen helped Johnny breathe and calmed him. Every few seconds, he’d cough and try to raise his hand back to his chest.

Charlie let out a low whistle at the sight beneath the shirt. A large bruise spread over John's mid-chest, with a visible deformity apparent in the sternum. Another arc-shaped bruise decorated his upper abdomen. “Looks like a probable sternal fracture.”

“Yeah,” Roy concurred, worry in his voice. A sternal fracture had the potential for life-threatening complications, as the heart lay directly below the protective bony plate.

“I’m thinking he went right into the steering wheel. The middle here is the steering post and this bruise looks like the outer wheel,” Charlie surmised.

“Johnny, were you wearing your seatbelt?” Roy asked as he firmly palpated Johnny’s shoulders, ribs and abdomen.

“Seatbelt?”Johnny parroted, confused. He thought for a moment before realization dawned on his face. “The accident!” he said, his voice muffled by the breathing mask, and he immediately became agitated. “Roy, the old man, he was in the other car!”

“I know, Johnny. Don’t worry about that now,” Roy said. To Charlie, he said, “Mild guarding of the upper abdomen. I don’t feel any rigidity.”

“No, Roy, he’s-...he’s hurt bad...you have to go...go help him! Please!” Johnny’s respiratory effort was increasing sharply in his excitement.

“Johnny, it’s being taken care of, man,” Charlie tried to assure him.

“He’s goin’ to the hospital?” Johnny asked.

Roy and Charlie exchanged looks. They didn’t want to lie to Gage but this state of agitation wasn’t helping his condition. He had already grown paler than he was just a minute before.

Roy made a decision. He leaned in closer to his friend. “Johnny...now, I want you to listen to me.” Gage’s brown eyes fixed searchingly on his friend’s blue ones. “That old man...he didn’t have a chance. He was probably killed instantly. I’m sure he didn’t suffer at all.”

Johnny squeezed his eyes shut as if to block out the words he didn’t want to hear. His breathing grew more rapid and shallow as his emotions escalated. A new bout of stubborn coughing ensued.

“Johnny, you’re making yourself worse. You need to slow your breathing,” Roy coached.

Charlie applied electrodes to Johnny’s chest and turned on the heart monitor. Roy watched the squiggly line as he kept up the reassuring dialogue with his distraught partner. “Roy, has he been sick? He’s sure coughing a lot.“

Roy shook his head. “No, not at all. He was at my house last night and he was fine.”

“I killed him,” Johnny choked out. “I killed him! He was just...an old man.”

“Johnny, the witnesses said he pulled right out in front of you. There was nothing you could have done. You gotta believe that.”

“Roy, what did you get for a pressure?” Charlie asked, preparing to contact Rampart.

“One hundred over 64.”Roy looked at the heart monitor and felt a modicum of alarm. An abnormal rhythm pattern crossed the screen.

“Rampart, this is Squad 51,” Charlie began to report.

“Go ahead, 51.”

“Rampart, we have a 28 year old male, involved in a motor vehicle collision. Victim was the driver of a vehicle that t-boned another car. He complains of sternal pain and dyspnea. Examination reveals severe bruising of the mid-chest, with obvious visual deformity of the sternum. EKG reveals elevated ST segments and low voltage QRS complexes; will transmit EKG to you momentarily. Patient is exhibiting a new onset of a frequent dry cough. Vitals are, pulse 122 and thready; B.P. 100 over 64; respirations 32, shallow and labored. Also, Rampart, patient’s radial pulse disappears with inhalation. We have him on 10 liters of O2. Request permission to start IV.”

Charlie adeptly started the approved IV on Johnny’s forearm. “Roy, he’s got some swelling in this wrist, it looks like.”

Johnny lay quietly, the back of his hand resting across his forehead. He found it hard to believe that such a beautiful day had suddenly gone so wrong. He couldn’t erase the picture of the old man that was now etched so clearly in his mind. The old man he’d killed, just minutes before, who lay dead in a mangled car just a few yards away. The more he thought about it, the more his anxiety grew. He started to feel he was being smothered. The oxygen was streaming towards his face but he couldn’t draw it in and his non-stop coughing only exacerbated the sensation. His eyes popped open and, in a panic, he started fumbling with the mask on his face, convinced it was suffocating him.

“Charlie, he’s got jugular distension,” Roy said. He listened to Johnny’s chest with a stethoscope, frowning at his findings. “Heart tones are muffled. His perfusion’s getting worse. We need to get him out of here.” Roy re-affixed the oxygen mask Johnny had knocked askew. His suspicions about the cough were becoming stronger by the minute.

“Roy,” Johnny protested breathlessly. “Can’t... breathe.” A new wave of perspiration broke out on his brow and he lolled his head from side to side.

“You need to keep that oxygen on, Johnny. It’s helping you.”

“No-- it’s killing me. I...can’t...breathe. Help me...”

“Rampart, this is Squad 51 with an update. Patient has developed jugular distension and heart tones are muffled. Coughing spells are increasing in frequency. Suspect cardiac tamponade. Patient is also exhibiting increasing anxiety and confusion.“

“51, if the ambulance is there, transport immediately. Monitor vitals every five minutes.”

By now Captain Hookrader and two members of the engine crew were standing by, observing the scene. The stretcher was brought closer and all the men assisted in lifting Johnny smoothly onto it.

“Let’s sit him up. That might help him,” Roy suggested.

“Cap, we’re both gonna need to ride in,” Charlie said. “Can you have the squad brought in?”

“You bet. Get going now and don’t worry.”

“Oh, and uh...Cap?”Roy said. “Could you contact the station and let Captain Stanley know what’s going on?”

“You got it, Roy.”

Once Johnny was loaded, Roy and Charlie jumped in the back, along with an ambulance attendant. It was a crowded space but all hands were needed. Charlie directed the ambulance attendant to get another set of vital signs. Johnny continued to grow more and more anxious, was markedly diaphoretic and starting to show cyanosis in his nail beds.

“Roy,” he panted. “Can’t breathe!” He kept his head tilted back to open his airway as much as possible.

“Johnny, you’re breathing just fine. Try not to hyperventilate. Slow your breathing.”

“Can’t...hurts too much!” As coughs racked his body, he clutched and released the cot handle repeatedly.

“Blood pressure’s 80 over 60,” the attendant announced. “Pulse 130. Respirations 36.”

Charlie got on the biophone to Rampart and reported the latest vitals. Roy quickly slit open Johnny’s jeans and began a secondary survey, running his hands over his legs and checking that his pelvis was stable.

“Looks like he’s got a knee injury,” Roy said, noting the bruised and swollen right knee.

“Roy, he’s going into shock,” Charlie announced.

The ambulance rocked and tilted as it sped towards Rampart. Dr. Brackett ordered a second IV and Roy kneeled on the floor to try to establish it.

“How far, Charlie?” Roy asked, sweat pouring down the sides of his face.

Charlie looked through the front window. “We’re pulling in now.”

Roy said a silent thanks. He looked at his partner who was now semi-conscious. His jugular veins stood out prominently in his neck, and his lips were tinged with blue. Strands of hair lay plastered to his forehead with sweat. He’s working way too hard to stay alive-- his energy’s gonna give out soon! All this because of a lousy auto accident!

Dixie stood waiting at the emergency room entrance, gown and mask in place, ready to direct the stretcher into a treatment room. She wasn’t expecting the patient to be someone she knew and cared about. Her eyes widened momentarily, but her professionalism overcame her shock.

“Treatment One.”

“He’s deteriorating, Dix. He’s gonna need a pericardiocentesis, I’m almost sure,” Roy said as they rushed the stretcher along.

“Dr. Brackett’s already waiting,”she said.

The entourage burst into the room and the wheels were set in motion. Johnny was quickly transferred to the exam table. Dr. Brackett stood waiting, gloves, gown and protective face mask in place. A nurse quickly stepped forward to draw blood. Another one worked to cut off the remainder of his clothes. Brackett shone his penlight into Johnny’s eyes and ran his practiced fingers over his skull.

“Blood pressure’s 74 over 60, Doc. He’s cyanotic.” Charlie pointed out the distinctive shape of the lesion. “Mechanism of injury was T-bone type collision. You can see the bruising from the steering wheel. He was conscious, alert and ambulatory on scene. Within a few minutes, he suffered a syncopal episode. He complained of dyspnea and sternal pain. Denied loss of consciousness at the time of the accident. He got more and more anxious as his breathing became more difficult. We got him on a mask but he was a little combative. His belly’s a little tender but no rigidity was noticed. His B.P.’s been on a downward trend, with narrowing pulse pressures, and his jugular distension has become more pronounced. Heart tones are muffled. He’s had a non-productive cough that’s gotten steadily worse. He’s got some other injuries, wrist, thumb and knee, nothing life-threatening.”

“Okay, thanks, Charlie. Good report,” Dr. Brackett remarked as he listened intently to Johnny’s chest. Roy stood back and watched, almost in a daze. He was relieved to be at the hospital but concerned things weren’t happening quickly enough.

“All right, I’m going to have to evacuate his pericardium.” Brackett looked around. “Anyone not sterile needs to leave the room.”

“Come on, Roy,” Charlie said gently, his hand on Roy’s arm. “It won’t take long.”

Roy took one last look back to see Johnny’s chest being bathed with betadine solution. “I hope he doesn’t feel it,” he said to Charlie.

“I don’t think he’s feelin’ anything right now, Roy.”

Both men looked up at the sound of approaching footsteps. It was the engine crew from Station 51, led by Hank Stanley.

“Roy, how is he?”

Roy sighed and rubbed his neck. He felt as if he’d already worked a full shift, rather than having just started. “It’s serious, Cap. He hit the steering post and fractured his sternum. There’s a build-up of fluid, probably blood, in his pericardial sac. It’s severely compromising his heart’s ability to function.”

“What are they doing? Is he going to have surgery?” Chet, Marco and Mike listened expectantly.

“Well, right now they’re trying to release the fluid. It might be all he needs.”

“How do they do that?” Chet asked.

“They insert a long needle and catheter into the pericardium...the, uh, sac around his heart. That way the fluid can drain out.”

Chet winced and rubbed his chest sympathetically.

“Is he conscious?” Marco asked.

“Not really,” Charlie said. “He’s semi-conscious at best. He probably won’t feel a thing. But they’ll numb him up anyway.”

“How long do you think he’ll be recuperating, Roy?” Hank asked.

Roy shrugged. “Well, the sternum can be pretty slow to heal if it’s broken; could take several weeks. And he’s got some other injuries. His knee’s banged up, and he might have a broken thumb. And his wrist is swollen.“

“Anybody know how this happened?”

“Evidently, the other driver pulled right out in front of him. He couldn’t avoid hitting him.”

“How’s the other guy?” Hank queried.

Roy and Charlie exchanged glances. “He, uh, didn’t make it.”

“Oh man, that’s gonna tear Gage up,” Chet said.

“He already knows about it,” Roy said. “It took quite a bit to calm him down on the scene. He kept insisting we leave him and take care of the old guy. Only-...there was no one to take care of. He was probably killed on impact.”

“Johnny was traveling westbound. The other driver might have been blinded by the morning sun,” Charlie theorized.

“Poor Johnny,” Marco said.

“Yeah,” Roy said. “I have a feeling that his physical recuperation is going to be only the beginning.”

Everyone nodded. They all knew how Johnny took things to heart. It would be a tragedy for anyone. But Johnny would likely beat himself up about it for a long time.

*****

Roy sat in the doctor’s lounge, an untouched cup of coffee in front of him. The engine had been toned out on a call, and Charlie had managed to catch a ride back to the station. Headquarters hadn’t found a replacement for Johnny yet and Roy was glad. He wanted to stay close to the hospital for as long as possible.

He didn’t know how long he had sat before the door opened and a weary looking Dr. Brackett entered, smiling encouragingly. He sat across from Roy.

“He’s doing better. The pressure is off his heart and his EKG is nearly normal. Blood pressure’s up too. That was a good call, by the way. You guys were on the ball with your suspicions. Thanks to you, we were set up and ready to proceed quickly.”

“I guess some of that training must’ve taken hold,” Roy smiled.

“Don’t kid yourself. You and Charlie are a couple of the sharpest medics we have.” Brackett winced. “Johnny too, of course.”

Roy blew out a breath and drummed his fingers on the table nervously. “What do you think his prognosis is?”

“I’d say it’s good. Right now, our main worry is infection. Having a catheter directly into the peicardium is rather risky, but in this case, the benefits far outweighed the risks. I’ve got him on some strong antibiotics to ward off infection.”

“Is he awake?” Roy asked.

“He’s awake, but groggy. His level of consciousness improved significantly once his heart started working better.”

“I’m not surprised.” Roy smiled, then became serious again. “What about his other injuries, Doc?”

Brackett sighed. “Well, now that we’ve got him stabilized, we’re looking into the other stuff. As we speak, x-ray is getting shots of his knee, wrist and hand. So far, we don’t know what we’re dealing with there. One or more of those areas may need surgical fixation so he hasn’t necessarily dodged the bullet just yet. I’m getting a skull series, too, just in case. He denied loss of consciousness but he may not really know and we don’t have anyone else to verify that for us. As for the little cuts all over him, we’ll get them cleaned up and they’ll heal fine. There’s nothing needing stitches.”

“So. How long until he’s out of the woods?”

“I’m going to keep the drainage catheter in his heart for 24 hours. That’ll be the most critical time. During that time, he’ll be in ICU under constant monitoring. I’m hoping he’ll show significant improvement and warrant a move to a regular floor in about two days. Barring any complications.” Brackett smiled ruefully. He and Roy both knew Johnny was the king of complications. “Then there is the issue of his other injuries. His sternum is probably fractured, and that could take a few weeks to heal. It’s a fairly painful fracture too, so he’ll be on some strong pain medications for a while.”

“When can I see him?”

“Soon as x-ray’s done. They’re probably finishing up now.” Brackett rose to his feet, followed by Roy. They left the quiet of the lounge for the hustle of the emergency department corridor.

*****

Roy pushed the door open hesitantly and looked inside. While Mike Morton gently tweezed the small particles of glass from Johnny’s face, Dixie followed with an antiseptic cleansing. Both looked up and smiled.

“Come on in,” Dixie beckoned.

Roy was happy to see Johnny’s eyes open and crinkle into a semblance of a smile. “Hey, Roy.” His words were slurred but the breathlessness was nearly gone.

“Hey, yourself,” Roy greeted him. Under the bright examination light, Johnny’s face still reflected the pallor of his ordeal, but was at least cleansed of most of the blood. “Looks like you’re getting the royal treatment. Is that really the job of a head nurse, Dix?”

Dixie shrugged. “By virtue of the fact that I am the head nurse, I figure I can pick and choose any job I want.”

“I guess that’s true.”

Johnny winced as Mike Morton extracted another sliver of glass. “She’s got a...nice gentle touch. Not like...some people.”

“Listen, Gage. Do you want your face full of glass? Then I suggest you suck it up.”

“Yessir.”Johnny blinked slowly.

Roy turned serious. “How do you feel?”

“Well...about the way I’d...expect to feel...after killin’ someone.”

Dixie shot a concerned look to Roy.

“It wasn’t your fault, Johnny,” Roy said. “It could have been anyone else besides you. You just happened to be...“

“In the right place...at the right time?” Johnny finished for him.

Roy looked at the floor. Is that what he had planned to say? Coming from Johnny, it did sound callous. Roy sighed. “Johnny...”

“‘M sorry, Roy. I know you...mean well. I can’t just...forget it...that easily.” Johnny hissed as another splinter was extracted.

“No one expects you to just forget it. But you gotta go easy on yourself. There wasn’t anything you could have done.”

“Yeah. I know.” Johnny was tiring quickly.

“Do you need some more pain medication, Gage?” Morton asked.

Johnny shook his head slowly. “Nah...I’ll live.” He snorted at the irony of his statement.

Dr. Brackett breezed into the room, bearing x-rays. “Okay, Johnny, I’ve got your films here. Let’s see what’s going on.” He snapped the films into the x-ray light box and turned on the lights. He studied the x-rays carefully. Dr. Morton set aside his task to join the senior physician. After a brief discussion, both doctors returned to the exam table.

“Well, you’ve fractured your patella and your thumb. Sternum’s broken too, no surprise there. Your wrist looks like it’s sprained only. Very common injuries in front end collisions.”

“‘Kay.” Johnny closed his eyes and swallowed.

Brackett waited for Johnny to say more, and when he didn’t, asked, “How’s your pain, Johnny?”

“It’s there.”

“Are you still feeling short of breath?”

“A little. Hurts to breathe.”

“He declined any more meds just a minute ago,” Morton said.

Brackett frowned. “Roy, would you get a set of vitals for me?”

“Sure, Doc.”

While Roy did that, Brackett listened to Johnny’s chest with his stethoscope.

“Blood pressure’s 120 over 90. Pulse 110,” Roy reported.

“Johnny, if you don’t object, I’m going to increase your pain medication. Your vital signs tell me you’re in pain, and that’s making your heart work harder, which is just what we want to avoid.”

“Okay, Doc,” Johnny said softly.

“I’ve contacted the orthopedic surgeon on duty, Dr. Heckman. He’s excellent. He’ll be in to assess your fractures momentarily. In the meantime, you need to realize you’re still one very sick patient.”

Johnny’s gaze met and held Brackett’s.

The doctor’s tone softened. “I know you’re upset about what happened today. But refusing to take care of yourself isn’t going to change the outcome of that accident-- except to possibly increase the death toll.” Johnny’s eyes widened. “Your condition is serious, Johnny. You’ve suffered a major trauma. You need to help us help you. That includes requesting pain medication when you need it. Your heart needs to recover from what happened and it can’t do that under stress.”

“I un’erstand.”

Brackett smiled. “So, do we have a deal?”

“Yeah.”

“Good.” He patted Johnny’s shoulder.

*****

By early afternoon, Johnny had had his hand and knee immobilized in plaster casts and been settled into an ICU room. His sprained wrist sported a splint. No measures were taken on his sternum as it was a fracture that typically healed on its own, albeit slowly.

Roy had gotten word that Johnny’s replacement for the shift had reported to work. Upon his arrival back at the station, he’d entered the day room to find the crew seated and having lunch. Craig Brice sat in Johnny’s usual spot.

“Brice,” he greeted distractedly.

“DeSoto.” Brice peered at him myopically. “How’s Gage?”

Roy nodded as he went to the cupboard for a glass. He sat at the table and poured himself some iced tea. “He’s doing much better. The next 24 hours are critical, but Dr. Brackett’s optimistic.”

Brice squinted. “I’m curious. Purely from a clinical standpoint, what were the definitive signs and symptoms in Gage’s presentation that steered you towards a diagnosis of pericardial effusion?” The bespectacled paramedic seemed almost excited.

Roy sighed and sank down into a chair. He suddenly felt extremely weary. “Well, Cr--uh, that is, Brice...they were the classic signs and symptoms. Obvious chest trauma, dyspnea, jugular distension and muffled heart tones... with narrowing pulse pressures and tachycardia.”

Brice listened, fascinated.

“Oh, and the cough, too,” Roy finished, taking a sip of his tea.

“Cough?” Brice asked, puzzled. His eyes took on a vacant look as he searched his memory banks.

“Yeah, you know, the--“

“Of course!” Brice interrupted, snapping his fingers. “The posterior bronchial encroachment of the pericardium, resulting in the tell-tale irritated dry cough!”

Roy rolled his eyes subtley. “Right.”

“Brilliant, DeSoto. I must say I’m impressed.”

“I must say I’m confused,” Chet interjected between bites.

Roy said to Chet, “Well, the important thing is, Johnny’s on the mend. That is, as long as doesn’t develop an infection or some other complication.”

“Amen to that, Roy,” Hank said. “Listen, why don’t you get some lunch? You look like you could use it, Pal.”

“That I could, Cap, that I could.”

“Sit still, Roy. I’ll fix you a plate,” Mike offered.

“How soon can we go visit Johnny?” Marco asked.

“He’ll be in ICU for a couple of days,” Roy explained. “Visitation is strictly limited there. If I were you, I’d wait until he gets moved out to a regular room.”

“I just can’t believe it,” Chet mused. “Only Johnny could have something this freaky happen to him.”

“Gage does seem to have a knack for getting into trouble,” Brice said.

The others stared at him.

Brice, oblivious, said, “Please pass the salt.”

*****

Roy visited Johnny twice more that shift, during patient follow-ups to Rampart. Johnny had been extremely fatigued and barely acknowledged his presence. Dr. Brackett assured Roy that this was a common after-effect of the injuries he’d suffered, not to mention the strong narcotics he was on, and nothing to be alarmed about.

The next morning at the end of his shift, Roy went home, showered and dressed in his civilian clothes. He ate breakfast with Joanne and filled her in on the whole story. After helping his wife clean up the breakfast dishes, Roy set out for another trip to Rampart.

Exiting the elevator on the ICU floor, Roy glanced over the groups of people sitting in the waiting area, their hushed conversations providing a muted backdrop to the serious tone of the environment. He glanced at his watch and saw that he had a few minutes left to wait. Roy took a seat.

He was soon aware of the presence of someone coming nearer. Roy looked up as a strangely familiar man sat next to him.

“Hi, I don’t know if you remember me,” the man said, extending his hand. “My name’s Dean Sullivan. I was on the scene of the accident yesterday.”

Roy nodded as recognition took hold. The guy who caught Johnny before he face-planted. “Roy DeSoto. I remember you now. I thought you looked familiar.”

“I came into the hospital to check on him. I’m sorry, I didn’t even know his name. So, I asked someone in the emergency department, and she knew exactly who I was talking about.”

“Sounds like Dixie,” Roy smiled.

“I couldn’t believe he ended up in ICU. Not after the way he got himself out of that jeep of his.”

“Really?” Roy asked, his interest piqued. “What do you mean?”

“I wasn’t really close, ‘cause I was checking on the other driver, but I could see what was happening. See, I’m a cop, and I’m used to maintaining a high level of awareness on accident scenes. So, anyway, his door was jammed, and he was desperate to get out fast. I saw him slamming his shoulder against the door, and when that didn’t work, he turned himself sideways and kicked at it until it opened.”

“I don’t believe it,” Roy said.

“That’s when I got involved. I thought he was so mad he was gonna run over and assault the other driver for causing the accident. It’s been known to happen, you know. People and their tempers.”

“Not Johnny.”

“No, I know that now. But I didn’t know him from Adam at the time, you know.” Dean paused. “So, he came runnin’ over there and demanded access to the victim. Said he wanted to provide medical assistance. Well, I‘d checked the old guy and I was pretty sure he was dead, and stayin’ that way. But I’m a cop, you know? I don’t have any medical training. I thought, maybe there’s a chance. So, I let him in.”

“And that’s when we showed up.”

“Yeah. I mean, the way he was acting, he didn’t seem hurt, except for those cuts on his face. I didn’t know he was hurt so bad or I would’ve made him sit down. And then when you guys came and took over, I watched him walk away, and I could see then he was bad off. I decided to go over and see if I could help him.”

“I’m glad you did,” Roy said. Since I let him walk away.

“Yeah, I figure I at least saved him from a bump on the head,” Dean said, grinning. “I’m just sorry I didn’t realize sooner how bad he was. Maybe he wouldn’t’ve gone downhill so fast. Maybe he wouldn’t’ve ended up here.”

“I don’t think it would have made a difference,”Roy assured him, although, in truth, he didn’t know. “Johnny had some serious injuries and they would have become obvious pretty quickly no matter what the circumstances.”

“Well, I hope so. I mean, I’m sorry he was hurt so bad, but I hope my actions didn’t make it worse.”

“I’m sure nothing you did affected his outcome.”

“You work with John?”

“He’s my partner.”

“Oh man, I didn’t know that! I just assumed you knew him casually, from working in the department.”

“No, he was on his way to work when the accident happened. The other guy with me, Charlie, stayed over because Johnny hadn’t arrived yet.” Roy shook his head at the memory. “Imagine our surprise when we got on scene and saw it was him."

“I don’t know how you guys do it. If something like that happened to my partner, I’d probably fall apart.”

“Don’t think I wasn’t close,” Roy said, smiling. “I guess something just takes over inside, makes you block out the personal aspect of it.”

“Thank goodness for that. I watched you guys take care of him. You’re real pros.”

“Thanks.”

The clock finally reached the top of the hour, time for the five-minute visiting period. Several people, including Roy and Dean, stood.

“Listen, Roy. I’m glad to get to talk to you. You’re at Station 51, right?”

“That’s right.”

“I’ll keep in touch to find out how John’s doing.”

“Thanks. Johnny’ll appreciate that.” The men shook hands.

“Okay. You’d better get inside before your time’s up.”

Roy ventured into the ICU suite and made a beeline for Johnny’s room. To his disappointment, it appeared Johnny was asleep again. He entered anyway and sat in the chair, causing it to creak lightly. Johnny’s eyes opened readily at the sound and he smiled weakly at Roy.

“Hey...what’re you doin’?” the patient asked drowsily.

“Just checking to make sure you’re behaving,” Roy answered, grinning. He gave his partner a good looking over. Johnny definitely seemed more coherent today than yesterday, but he didn’t look much different otherwise. He was sitting straight up, pillows behind his back for support. The bruise on his chest peeked out from behind the neckline of his hospital gown. His arms rested on cushions and his knee was propped in a slightly bent position. He still sported a nasal cannula for oxygenation.

“I’m a model patient, Roy,” Johnny slurred. The smile on his lips didn’t quite reach his eyes.

“That’s not what I hear,” Roy teased.

“Don’ believe ever’thing...you hear.” Johnny grew pensive. “I’ve been doin’...a lot of thinkin’ Roy. ‘Bout the accident.”

Roy waited, giving him plenty of time to talk.

“I remember readin’ somewhere...or maybe I saw it...can’t remember...” Johnny paused as a wave of pain washed over him. “Anyway...it was about train engineers.”

Roy wondered if this were really going somewhere or if the drugs were doing the talking for his partner.

Johnny went on. “They talked ‘bout, when people...decide to kill themselves...by jumpin’ in front of a train. Or, a car stalls on the tracks...an’ they can’t stop it from happ’nin. But it makes ‘em feel really bad. Makes ‘em feel...responsible somehow.”

“I can see that,” Roy said softly.

“Well, at the time...I thought it was...int’resting. But now...now I know...kinda how they feel. S’like I joined...some unpopular club.” Johnny’s eyes drifted shut.

Roy sat and thought about what he’d said. He couldn’t deny the truth in Johnny’s words. Even though the accident wasn’t Johnny’s fault, it was naive to expect him not to feel anything. But he had to try to keep Johnny from blaming himself excessively. There was a difference between feeling bad about something and feeling responsible for it.

“Visiting time is over,” a nurse said quietly, interrupting Roy’s thoughts.

Roy acknowledged her with a smile and stood up. Five minutes sure passed quickly. He stepped over to Johnny and laid a hand on his shoulder. “I’ll see you soon, Partner.”

Johnny nodded, his eyes still shut, a wan smile on his face.

*****

Roy exited the elevator into the emergency department. He felt more at ease here than in the ICU. This was his territory. He wandered to the nurses’ station and was delighted to see Dixie working.

“Hiya, Dix.”

“Hi, Roy! Are you here to see Johnny?”

“I just saw him, actually.”

“I’m planning to get up there soon and check on him. How’s he doing?”

“He seems a little better today, a little more with it.” Roy didn’t seem particularly happy.

“But?” Dixie asked, sensing Roy’s mood.

“Well...I thought maybe you’d have some idea, you know...of how we can make him...”

“Not blame himself for that old man’s death?” she finished for him.

“Yeah.”

“Roy, you know your partner. Beneath that goofy exterior is one tenderhearted man. Now, I know he’d be mortified to hear me say that.”

“It’s true, though,” Roy readily acknowledged. He thought about Dean’s story.

“You bet it is.”

“I guess he’ll just have to work his way through it. The rest of us can provide support if and when he asks for it.”

Dixie tapped her pen on the desk. “Tell you what. I’ll have a little talk with Johnny today. See if I can make some headway with him.” She winked.

****

Dixie chose an uncharacteristically slow time in the emergency room to journey upstairs to the ICU. Since she was a nurse, she had greater latitude in length and timing of visits to patients there. She entered the ward and passed the nurses’ station to make her presence known, then entered Johnny’s room. She found him sitting up, just as Roy had. He stared through half shut eyes at the television mounted on the wall. Dixie got the impression he wasn’t really seeing what he was watching. His gaze roamed disinterestedly her way when he heard her footsteps, but his face lit up when he realized it was she and not one of the unit nurses.

“Hi, Johnny.” She smiled warmly.

“Dix. S’good to see you.”

“I wish all my patients were so happy to see me.”

Johnny frowned in mock seriousness. “You didn’t...bring a needle or anything...did you?” His eyes twinkled mischievously.

“Maybe that’s the secret,” Dixie agreed, chuckling. “How do you feel?”

“Like I’d be a millionaire...if I had a dollar...for every time...someone asked me that.” Johnny said haltingly.

“Well, you must be feeling better to be able to joke about it. But seriously, Johnny...are you doing okay?” The dark circles beneath his eyes and the tension in his face belied his attempt at humor.

“Seriously...I’ve felt better...I have to admit.” Johnny let down his guard as a sharp pain lanced his chest. He was nearly due for more medication.

“Is it your chest?” she asked.

“Mostly,” he admitted. “Every time I breath...it hurts. Guess I should just...stop breathin’.” He smiled.

“Don’t you dare!”

“Nahhh...I wouldn’ dream of it...after Brackett worked so hard to...save my sorry ass.”

“Why do you say that?” Dixie asked sharply.

“I know why you’re here,” Johnny said. “You wanna...make sure I’m not...still upset...’bout yesterday.”

Dixie crossed her legs. “Can’t fool you.”

“Did Roy...put you up to this?”

“I won’t deny that Roy and I had a conversation. But no, it was my idea to come see you.”

“Dix, I’ll be fine...eventually. I’m not stupid. I know, in my head....I know it wasn’ my fault. But--“

“But?”

Johnny clenched his jaw, considering his response. “You don’ know-...at least, I hope to God you don’...how it feels...to be respons’ble for...the death of another human being.” He started to raise his hand to his chest, then remembered it had a cast on it and set it back down. “It’s just gonna...take me some time.” He looked at her, his eyes pleading for understanding.

“Oh, Johnny.” She rested her hand on his forearm. “You’re certainly not stupid. But your logic is flawed. Don’t you see?”

Johnny’s brow knit in confusion and he blinked his drug-glazed eyes.

Dixie smiled. “Just listen to yourself. First you say ‘I know it wasn’t my fault.’ Then you say ‘you don’t know how it feels to be responsible for someone’s death.’ How can you be responsible for something that wasn’t your fault? What happened yesterday was beyond your control, Johnny. As ignoble as it may seem to say this, the fault lay with the victim. I know it goes against your grain to project blame onto someone else. That’s not really what I’m talking about, placing blame. I’m talking about you absolving yourself, and rightly so. So that you can get past this and back to the good work you do every day, helping so many people.”

Johnny looked down, took a deep breath, then released it shakily. Without looking at her, he asked Dixie, “How’d you...get to be so smart?”

“I’ve always been smart, John Gage. It’s about time you realized it.”

“Maybe I’m finally...comin’ to my senses. ‘Bout time, huh...”

“No, Johnny. There’s no shame in having too much compassion. Unless it’s for everyone else and not yourself.”

“Then, I guess...it’s a good thing...I got you to straighten me out.”

“I’m always here for you, you know that. And so is Roy. He’s been very worried about you.”

Johnny’s head nodded almost imperceptibly. “I’m pretty lucky...aren’ I?”

Dixie shook her head in wonderment. “If you can sit there in that bed, with your injuries, and call yourself lucky, then one of us is doing something right.” She paused. “You’re a special person, do you know that?“

“Don’ embarrass me, Dix.” Johnny shifted restlessly in his bed, grimacing at the pain his movements caused.

“You’re right. That would ruin my tough-as-nails reputation.” Dixie started to rise. “Listen, I’ll be back to embarrass...I mean, check on you...later.” She brushed a lock of hair off his forehead, then turned to leave.

“Dix?”

“I know, Johnny,” she replied in her smoky voice. “Get some rest now.”

Johnny watched her leave, thinking I will get some rest now, thanks to you.

*****

“Goooood mornin’!” Johnny, smiling broadly, entered the day room through the back door. He wore a plaid shirt and a pair of jeans. In his hand was a white bakery box. The members of the crew stopped what they were doing and converged on him.

“Johnny!” Roy exclaimed. “What are you doing here?”

“Yeah, Gage,” Chet said. “I know you missed us, but what makes you think we missed you?” Chet’s barb was diminished by the concerned way he studied his co-worker and the gentle pat on the back he gave Johnny.

“Kelly!” Hank admonished.

“Thanks a lot, Chet. I’m overwhelmed by your sentiments.” The smile never left Johnny’s face as he slowly walked to the table and set the box down. His gait still held a slight trace of the limp he had acquired from his broken kneecap. His hand and forearm still sported the now scuffed and well-worn cast, but his other wrist had healed from its sprain. The cuts on his face had all healed, leaving no scars.

“You’re looking good, Pal,” Hank said.

“Thanks, Cap. I’m feeling good too, for the most part. Can’t wait to get this thing off.” He held up the cast on his hand.

“How much longer?” Roy asked.

“Dr. Heckman says maybe two more weeks.”

“What’s this, Johnny?” Marco asked, indicating the box.

“Just some donuts, Marco. Dig in.” The paramedic watched with pleasure as the crew tore into the white box, each taking one of the sinful treats. “I owed you guys these for a long time,” Johnny said, almost to himself. “Consider it a past-due payment.”

“What’re you talking about?” Hank asked, his mouth full. “Roy, what’s he talking about?”

Roy shrugged. “Beats me, Cap.” He took another big bite of his Bavarian cream.

“You don’t owe us anything, Johnny,” Mike Stoker said.

Johnny grinned shyly. “Let’s just say...it’s my way of showing you guys how much I appreciate, uh--well, being part of the best crew in L.A. County...including you, Chet. And I really mean that. From the bottom of my heart.“

Good-natured laughter filtered through mouthfuls of donut. Johnny felt genuinely happy and at peace. I am a lucky man.

I want to express my thanks to Alice and Pat for the beta reads. This is dedicated to my staunchest supporters (naggers?)-- they know who they are. Thanks also to MJ and Tigger for the contest idea and for the fantastic fanfiction sites they own. And, if you’re reading this, you must have read the story, so thanks to you, the reader!