"Dog's fine," the medic says. "Dog left first."
"Smart dog." I get Mr. Kessler on oxygen and a monitor, listen to lungs that sound like a screen door, order the chest film and the carboxyhemoglobin, and I am mid-sentence with respiratory when the second rig arrives and brings the noise.
The noise is a firefighter.
Debbie spots him from the station and lights up like a scoreboard. "Owen Peterson! You were supposed to come eat, not bleed—"
A monitor alarms down the hall and she's gone, pointing at him as she backpedals. "Don't you leave this building!"
He barely registers her.
He comes through the doors on his own two feet, which is his first mistake, because men who walk in think they get a vote. Turnout pants, suspenders down, soot to the elbows, and a gash up his left forearm that has bled through one pressure dressing and started on a second. Big. Built like the business end of an axe. Jaw you could strike a match on, currently clenched.
And he is not talking about his arm. He is pointing across my ER at my patient.
"He was in that smoke eight, ten minutes before we got him out. He needs a CO level and a chest X-ray, and somebody needs to watch him, because these old boys minimize—"
"Sir."
"—and if his sats look fine on room air that doesn't mean anything with carbon monoxide, the pulse ox reads wrong—"
"Sir."
He keeps going. He's telling my respiratory therapist, a woman with nineteen years of experience, how a nonrebreather works.
So I step into his line of sight, plant myself there, and wait. It takes him a second to notice, the way it takes a freight train a second to notice a cow.
"You're bleeding on my floor," I say.
He glances at the arm like it belongs to somebody else. "It can wait."
"It's dripping. Dripping doesn't wait, it accumulates."
"The patient—"
"—has a nurse, a respiratory therapist, oxygen, a monitor, and a provider. Me. I ordered the CO level and the chest film before your rig cleared the driveway. What he doesn't have is a stranger in turnout pants directing traffic over my shoulder." I point at Trauma Two. "That bed. Sit."
He looks at the bed. Looks at me. There's a whole argument happening behind his eyes, and I watch him lose it.
"Fine," he says, like he's doing me a favor.
"Bless your heart," I say, like it isn't a threat.
He sits on the edge of the bed the way men sit when they're planning to leave. I cut the ruined dressing off and take a look. The laceration is long, deep at the middle, edges ragged. Metal, probably. It's going to need a layered closure and he's lucky it missed anything that matters.
"How'd you do this?"
"Barn had opinions."
"Tetanus current?"
"Yes."
"Allergies?"
"No."
"Charming personality, or is this a head injury?"