Ambrose Ibsen [Ibsen - Beyond

The firefighters leaned into the Volvo with their hydraulic shears, and after a lengthy effort managed to crack the gnarled metallic shell, extracting the driverlimp and unresponsivelike a sunflower kernel. Now came the hard part; paramedics swarmed around the gurney to begin the rather involved work of sussing out signs of life in the scarlet assemblage of broken parts.

Can you hear me? asked one of the first responders. Out came the penlight. A hand spread each of the eyelids in turn. Fixed and dilated.

He ain't breathing, noted another. He swept a few gloved fingers into the victim's mouth, ensuring the airway was clear, and then began CPR.

One of the first responders yanked aside the neckline of the blood-streaked polo and engaged in a forceful sternal rub; there was a reaction in the victim, but it was a feeble stirringnothing that would inspire confidence. It was the trembling of a supine housefly on a windowsilla last gasp.

From one of the bystanders, the college-aged girl who'd dialed 9-1-1, He was speeding, but I don't know what made him lose control. One minute, he was trying to pass all of us who'd stopped to watch the sky, and the next he suddenly hooked to the right and flew through the railing.

The decision was made to move immediately to the ambulance, and so the gurney was dragged up the inclineaway from the heap of twisted metal with Ohio plates, away from the sequence of divots it had left in the field during its precipitous decline, away from the ruptured safety railing it had burst through at no less than seventy miles an hour. The patient was hoisted into the rear of the vehicle, where still others waited to work on him in vain. The whine of a defibrillator could be heard as they rolled him into place; the crinkling of plastic IV tubing and the jangling of vials filled the brightly-lit space like a funerary dirge.

The ambulance wheeled away from the shoulder and pulled past a line of stopped cars half a mile long. The motorists had stopped initially to see the comet pass, but had stayed to watch the rescue unfold, and now they weaved lazily to one side or the other to make room for the screeching ambulance. The flashing reds and blues chewed up the dusk as the vehicle picked up speed, and the roar of the siren waxed deafening.

Meanwhile, in the back, the paramedics struggled to work against the gyrations of the speeding ambulance on a man to whom life clung as tenuously as a breath on cold glass. The further their assessments and interventions went, the more destruction they discovered within him. There was more brokenness to the man than wholeness; where they pressed in with their palms to kickstart his hibernating heart, they encountered the clacking friction of displaced and splintered bones, and where they tested his limbs for reflexiveness and sought out a pulse, they found only that blood had begun to accumulate in sectors where blood oughtn't pool. It was a losing battle, and they knew it.

He looks young, lamented one of the paramedics, wiping the sweat from his brow.

Probably a student, suggested the other.

He was indeed a youthful specimen. From what could be gleaned beneath the veneer of blood and sweat, the victim was possessed of a boyish countenance; though the impression of immaturity may have been owed at least partially to the expression he woreone of static and terrific alarm. His eyes were thrust wide, and though little light remained in them, they seemed to twinkle with latent horror; his jaw was slack and his mouth drooped open in a silent scream. All this was noted and documented by the paramedics before they rifled through his pockets and produced an ID. The victim was identified as one Erich Tellier, twenty-two years of age, and evidently an undergraduate at the nearby Moorlake University.

Stay with us, Erich, said one of the paramedics as the vehicle whipped into the rear lot of the university hospital, though whether the patient maintained sufficient consciousness to appreciate the use of his name remained unclear. Already one of the EMTs was on the phone with the on-call trauma physician; the young paramedic doled out the dire assessment on one end, and from the other came a series of learned and increasingly despairing grunts.

The doctor, a ten-year veteran of emergency medicine named Schneider, stood among the personnel that gathered at the rear entrance, and ordered the paramedics to rush the gurneyby then oozinginto the trauma room, where preparations had been made to yank this Level One back from the brink.

And it was there that the assembled staff, some twenty-five persons thick, toiled to save the life of Erich Tellier for nearly an hour.

Nurses searched for good veins; respiratory therapists took turns doing chest compressions with clinical supervisors; carts of supplies were thrown open and the cold suite was turned sour and warm by the cloistered breathing of its laborers. And all the while, Schneider stood by, masterfully directing operations like a conductor might direct a symphonya stone-faced, blood-flecked Leonard Bernstein.

But it was all for naught.

Life would not return to Erich Tellier.

Schneider held up a closed fist and bellowed, Enough, past the staff's murmurings and at that moment they all drew away from the gurney, exhausted, not a little distraught, but comforted in the knowledge that they had applied more than 2000 years of medical expertise in their attempted resuscitation.

We made a good go of it, summarized one of the orderlies, his scrub bottoms pink with blood.

Glancing at the Seiko on his wrist, Schneider noted the time of death on the back of his freshly-scrubbed hand in black ballpoint and strode out of the suite, instructing those remaining to clean him up. The time of death that he would transfer onto a progress note some minutes later was 8:45 PM.

The patient had been lostthe sterile euphemism of choice was expiredbut there remained a good deal yet to do. To start with, the suite needed cleaned and the body of Erich Tellier made presentable; this former goal could be accomplished with buckets and mops, whereas the latter, considering the patient's miserable final state, would require nothing short of sorcery. The best the nurses could hope for would be to wipe the bulk of the blood from the corpse, to remove the lines from him and to arrange his battered limbs in a hopeless, but respectful, imitation of comfort. There remained, too, the least enviable task, which Schneider would take upon himselfthat of contacting the patient's next of kin and breaking the news.

The physician busied himself at the nurse's station for the next twenty-five minutes, taking down a few pages of detailed notes on the incident. The full extent of Erich Tellier's injuries would be impossible to determine without an autopsy, though Schneider felt comfortable in declaring a number of points in his notes, any one of which might serve as an official cause of death. The patient had suffered from broken ribs; he and the other staff had felt them during compressions. Pneumothorax was suspected. That the patient had bled internally was plain, and what's more, the presence of brain trauma had been made clear by the fixed and dilated pupils. Though he could not say with absolute certainty, the state of the body, coupled with its utter lack of reflexiveness, seemed to point to a spinal injury, and his cursory examination of the spine