The Perfect Ten

"Sixty-six year old female, chest pain."

The roads are rimed with ice, thick in places, bumpy, dangerous. Cable chains, coupled with tremendous weight, give our aid car traction and mobility. It's two in the morning, and we are hurrying on the treacherous streets, closing distance with the medics. The address is at a mobile home park, "The Estates", a manicured ersatz village brimming with retirees, trailers lined up in tidy, landscaped, aluminum rows. We go there often.

At the station, Rich had stared sleepily at the map on the wall, pulling on his bunker pants. "I don't know where we're going."

"It's by the freeway." It had sounded so helpful in my head, before I said it. I try to coax my groggy mind into showing off with turn-by-turn directions. "Follow the medics. They know where they're going."

We lose sight of their flashing red and white lights. A dispatch to "chest pain" is urgent in itself, but a slow start and an icy night make me anxious. The medics have made the only possible turn, and when we come around the corner, we can see them again, two blocks ahead. I'm in the officer's seat, pulling on nitrile gloves, Rich is focused on navigating the slippery route - slow on the corners, faster on the straights. He closes the gap between the two vehicles, and I relax a little.

We arrive seconds behind Medic forty-six, parking behind them, and uphill on the glazed asphalt lane. A narrow set of stairs leads up to the door under the carport. I wait at the bottom, until the medics are inside. Last week, I was bringing a gurney into a similar mobile home, and my foot went through a rotten plywood step. I bounce experimentally on the treads, assessing their strength, should we need to carry a patient out this door - no cracking or creaking under my weight.

I enter the home, and a woman is flitting about at the front door. "I was hoping they'd send some handsome firefighters!"

"Nope," I deadpan, "They sent us, instead."

I expect her to usher us to our patient, but one of the medics, Eric, asks her to take a seat and launches into interview mode. I've got a report and clipboard in my hand, and it's my role to record patient demographics (name, age, address), medical history and chief complaint. I'm still groggy, and I strain to make sense of the conversation, recording pertinent facts. No one asks her name, so I scan the counter for medications. I pluck a bottle, empty of oxycodone, from the window sill. I squint at the label.

"Are you Peggy?"

She is and she has a host of medical issues, none of them cardiac related. But because she uttered the magic words to dispatch, the medics are chasing down the chest pain path. They hook up the cardiac monitor, sticky little blue patches connected to wires at her shoulders and hips, under her robe. Nothing remarkable.

"The pain is right here." She thumps her belly with a closed fist, below her ribcage. "It goes to my stomach, and chest. And my back."

Roger leans her forward and palpates her back in several places. She jumps a little when he presses her flank, in the middle of her back.

"Oooh, right there."

"Well, Ma'am, I don't think this has anything to do with your heart. But, these boys will be happy to take you up to the hospital... -if you want." Boys. Rich and I are both over forty. But it sounds down-homey. I let it slide.

She wants. Happily, she can walk just fine, and no one is too concerned if she does, but we would be for a patient in cardiac distress. Rich and I each take an arm, and steer her toward the door of the aid car, mincing our steps on the packed ice. She has some difficulty climbing in, due to her bum knee, but I don't want to lift her on the gurney, on this icy hill, if I don't have to. We take our time and soon she's belted into our bed in the back of the aid car. The heater barely maintains 68 degrees F, against the bitter cold outside, but I shake off the chill, and call the nurse, while Rich starts us in the general direction of the two hospitals.

I flesh out the report in the back of the rig, while we bounce along. The document constitutes a legal and medical record of the event, and different types of calls require specific information. She was never asked her to rate her pain during the interview.

"Ma'am? On a scale of one to ten, how would you rate your pain? With one being no pain, and ten being..."

"Ten."

"...being the worst possible pain imaginable?" Like losing a leg in a meat grinder, like getting impaled on a fencepost, like giving birth to quintuplets - simultaneously?

"Oh, it's a ten." She smiles at me, nodding. Her hands are folded across her generous lap.

"Okey-doke. Ten out of ten. Got it. Thanks." I bend to the paperwork, making a note of her statement, but I frame it in quotation marks, in the subjective section of the report.

I reckon I've experienced 7/10 pain, and it made me sob. But I've seen 10/10 pain. I've heard the wailing, the moaning, the pleading for it to stop. The desperate writhing. The gnashed teeth, enamel squeaking, the clenched knuckles, squeezed bloodless, white. Ten out of ten? Balderdash. Hooey. Confabulation. Steaming bullshit.

There's no traffic, and despite the ice, we arrive at the hospital shortly. After a short wait, we are sent to a room at the emergency department. Peggy wriggles from our gurney to the hospital bed, after we raise the latter to the same level. There hangs a new flat screen monitor on the wall which monitors and displays vital signs. I like technology, and I comment on the addition to the room.

"Oh. I thought that was a TV. Isn't there a TV in here? I am so thirsty." She is sitting up, gazing about the room. "I thought there'd be TV..."

The admitting nurse has followed us into the room. "Nope. Sorry." She doesn't sound very apologetic.

I give her my short report, epigastric pain, radiating to the chest, abdomen, and back. I high-light the ten out of ten rating with animated fingers.

"Right." She looks blankly at me. "Worried about TV and a drink?" She smiles sweetly, and shrugs a little. "A ten? I don't think so."

"I know..." I tear off the pink copy of my report and hand it to her.

"Thanks. You have a good morning."

"You too." I call over my shoulder, "Bye Peggy! Hope you feel better." Rich is waiting in the idling rig, the cab heater blasting.

"Let's go home, Cowboy. I'm sleepy - A ten out of ten."