“Signs Incompatible with Life”

I’m not late. This morning, like all mornings, I head out on my bicycle while the moon is still bright, take three different buses, and then pedal my legs numb until I see the fire station. As I arrive the eight members of my crew are outside, washing the rescue truck and the pumper and my ambulance.“I’m not late,” I say, coasting into the apparatus bay.

“You’re not early, Elaine,” Captain Cruz says.The captain knows I no longer drive but the unofficial rule is: Thirty Minutes Early or You’re Late. We got this new guy at the station awhile back. He couldn’t appreciate the unofficial rules, so the rescue truck boys dumped sacks of flour on him in the shower, removed and hid the tailgate from his pickup, signed him up with RoughSexWanted.com, and called him nonsense nicknames until he transferred stations.

I toss my bike against a wall and grab car wash soap and a scrub brush. I mix the soap and water in a yellow mop bucket, and I tell myself, Head down and do the dirty work, Elaine. No one bothers you when your hands are full and filthy.

I roll the rickety mop bucket over and scrub a galaxy of dead bugs off the front of my ambulance. As I work, I try not to imagine the prank the rescue truck boys have waiting for me. I brush away the images of past pranks, of things they like to do with dead fish, itching powder, the sex offender registry. I’m blasting the ambulance with the hose, rinsing away the soap bubbles and death, when the side door flies open.

“What’s the first sign of an aortic aneurysm?” Rachel asks, leaning out the ambulance holding the promotional exam study guide.

“Crow’s feet,” I say. “Fallen arches. A narrow ass.”

Rachel bops me with the guide and heads inside to study. We’ve been partners since I joined the department 3 years ago and I trust her; she does all my driving. Recently, Rachel is carrying the study guide everywhere—into the hospital, into the toilets, into the bloody backseat of a crumpled station wagon after it rolled across fourlanes of highway. Rachel keeps the guide so close because she’s smart and she’s going places and the exam is in three weeks. During our last shift, she nailed all one hundred questions on a practice test, so I gave her an enthusiastic high-five and went out back of the station and put my head between my legs.

Ten minutes pass. I scrub the truck and blast the hose and look over my shoulder. Nothing happens except the sunrise. I start in on shining the tires and the station alert tones go off. The noise is high-pitched and awful, and ever since I flipped our old ambulance with Rachel and a patient in the back it makes my heart race. Double-time at night, if I’m actually asleep when the call comes in.

I climb in the passenger seat and pull up the dispatch info on the tablet. It says we’re headed to the home of an elderly woman for an unknown medical problem, no further details. I open a run record and begin inputting the information, something I do on every call, because after I caused the wreck, I proposed to Rachel a deal: I take all the patients and write all the reports and she does all the driving. Rachel tried to say the deal was unnecessary and dumb, that she trusted me, that the wreck was unavoidable. Maybe you could say she never formally agreed to the deal, and maybe you could say I never told her that I break out in cold sweat and lose the feeling in my feet just thinking about driving. Maybe you could say I forced the deal upon her.

A moment later Rachel jumps behind the wheel, hits the emergency lights, and guns it out of the station. She takes a hard left into the street and fires up the siren, and I navigate with my head down, my eyes narrowly focused on our little blue dot tracking along the map, another race to another life-altering emergency.

“Eat shit,” Rachel shouts, blasting the airhorn. “Move to the right, shiteater.”
“Take the next left turn,” I say. “Forty-Eighth Street.”

I never look up from the tablet, not when Rachel curses a school bus, and not when she makes the turn without slowing down, actually she speeds up to turn, taking the corner on two wheels, the siren blaring Hi-Lo. I tighten my two-handed grip on the tablet and watch our blue dot slide up next to the location. I holler out to stop, and Rachel
stands on the worn out brakes, bringing us to a shuddering halt.

“What’s the leading cause of line of duty deaths?” Rachel asks, grabbing her study guide off the dashboard.
“Fire axes,” I say. “Suffocation by pillow. Rat poison in your coffee.”
“I read somewhere,” she says, flipping pages, “that it’s lack of mental health care.”
I hop out of the truck, grab the medical bag from the back, and trudge up the gravel driveway. The location is a faded yellow house, small and falling in on itself, somehow collapsing through its own front door. Like many of the homes around here it looks abandoned at first glance, but Rachel and I know better. We regularly treat people living in tool sheds, immobile RVs, horse stables. We once returned from a call and found two winos inside the station eating our lunches and watching daytime television. The fat wino bitched about my tuna salad recipe and our lack of premium cable channels.

Inside the yellow house, we find the patient slumped in a wheelchair. She’s got herself pulled up to the kitchen table, which is a mess of hospital discharge paperwork and medical bills and food waste. Her eyes are open as I approach, though she doesn’t look up at me.

“Hello?” I say. “What’s the trouble?”
“I…drank bleach,” the patient says, her voice raspy and halting.
“How much?” Rachel asks. “We’re you confused or trying to hurt yourself?”

The patient points to a supersized gas station cup on the table, her hand hesitant and shaky, her fingers mostly knuckle. “I drank bleach,” she says.

I grab the cup, and find it overflowing with used diabetes needles and a cloudy bleach-smelling liquid: the patient’s DIY sterilization process. I show it to Rachel and she understands. She can read my face the way other people read lips.

I kneel down to check lung sounds with the stethoscope and Rachel looks in the patient’s mouth. As we work, the patient looks back and forth at the two of us. Her eyes are wild and blank and they contain no understanding. But still, they are living eyes.

The patient’s breathing is good, so I squat down and put my face in her line of sight. I wait until her eyes catch onto mine, until she stops searching for a familiar face that she will not find.

“We’re going to the hospital,” I tell her,

because I can control this situation, I can put my hands on her and steer her back to health. Then Rachel and I lift
her body onto the stretcher and move out to the ambulance.

“I’ll ride this call,” Rachel says, hopping inside the box.

As I latch the stretcher into the floor-mounted bracket, Rachel sits at the patient’s right arm and prepares to start an IV, like she doesn’t remember our deal. Like she doesn’t remember the last time I drove, doesn’t remember the sudden stop and the world turning over.

I climb inside and sit on the bench on the other side of the patient. I watch Rachel insert the IV needle, smooth and confident, watch the patient’s skin break and the blood flashback in the chamber. I watch Rachel cap the open end of the catheter and secure it down with tape.

“There you go, ma’am,” Rachel says, placing the patient’s hand back in her lap and turning her face to mine. “Now it’s just an easy drive to the hospital,” she says, her eyes firm and gracious.
The last time we played this game—our version of chicken—it was late, hours and hours past dinnertime during a busy shift. I came out of the burger joint with our food, two overstuffed paper bags, and Rachel was sitting in my seat, there on the passenger side. The truck was running and she had the seatbelt on, pulled tight across her chest, and I stood there in the parking lot and ate both bags of food as she watched.

With the patient seated between us on the stretcher, Rachel sits back in her seat, letting me know she’s prepared to wait it out this time. I watch her chest rise and fall, counting out her respiratory rate, measuring her calmness against the jailbreak going on in my chest.

“I drank bleach.” The patient lifts her arm and squints at the catheter.

She begins to pick at the tape holding it in place, and finally Rachel breaks, she reaches forward and pushes the patient’s arms back down, and I jump out of the truck.

I go around to the driver’s side and fling open the door. I reach for the ignition, snaking my arm under the steering wheel, but my arm is too short. To reach the keys, I am forced to half-sit in the driver’s seat, and I feel the truck idling under my ass, and once again it is 3am and dark and I do not see the man in the road until it is too late. I come back around the truck with the keys hot in my hand and toss them at Rachel’s chest.

“Hospital is only four miles from here,” Rachel tells me, like distance is a factor.
“Two right turns and one left.”
“Great news” I say, placing my hand between us, on the patient’s forearm.
“Rachel knows the route to the hospital.”

In the morning after our shift is over, I go out in the apparatus bay and find my bicycle frame—no wheels. I slink around looking inside the trucks, on the hose racks, in the oxygen room, and I hear the rescue truck boys chuckling louder each time I guess wrong.

I find the wheels hanging from the flagpole.

The boys jump out finally, wrenches and phones in hand, laughing and filming it all. “Elaine,” they say, “what’s your problem.”

They say, “Elaine, show us how you get home.”
I know the unofficial station rules: Early is on time, Work as a crew, Call for help when your ass needs saving. I know what I should say, now, to the rescue truck boys, to anyone who’ll listen. To Rachel, who is watching from inside the station, waiting for me, the way she does.

Jacob Rutherford lives writes and works in Houston.