The Kind We Keep

All of my life, ever since I was a child, has been death. It started with my parents, who died when I was six. Their cab turned over on one of the few nights they went out without us. I understood more than I should have at that age. More than my brother did, anyway. Ezra shut down after that. I went the other way. I felt everything, too much, until I learned how not to, how to compartmentalize. I don’t think of my parents as often anymore but I do wonder every once in a while how different my life would have been if they were in it. We were sent to live with our aunt Tracy, who smoked herself half to death before the decade was out. She was the kind of woman who existed in the background. The hum of the television, the smell of cigarettes through the walls. Ezra was a quiet kid until he wasn’t, and I became the adult. I was taking care of my big brother on my own. When she finally went, I felt immensely guilty. Not just for her, but for all of the people I couldn’t save. Which I suppose is what led me here.

“That really sucks, y’know? People coming down to the city, trying to have a good time.” Don says, driving our ambulance truck back North from the hospital. “Next thing you know you got a crooked nose cause you opened your mouth to the wrong person.”

“Then you’re bleeding from the moneymaker.” I add to his comments.

“Mhm. Get yourself popped right in the face.” Several brilliantly funny remarks crowd into my mouth and fight for space on my tongue, and I thought I could somehow make myself stay focused on the larger point, but alas…

“Damn, he caught a bad break.” I joke and Don can’t help but chuckle.

“Oh man.” He shakes his head and snickers.

“There you go.” I laugh and mock a rimshot drum.

“We need two units nearby.” Our radio sounds. “You’re gonna be responding to multiple gunshot victims. We have a female experiencing a loss of consciousness and a male. Please stand by to reinforce PD.”

Don immediately turns on our sirens and I take a deep breath before responding.

“Medic 22 en route.” I turn off the radio. “More GSWs. What you thinking?”

“Probably another street fight.”

“Nah, in this area? Too nice. You think it’s a domestic dispute?”

“I don’t know, Iris. People are crazy. This guy got shot over a pack of smokes the other day so you never know.”

“That’s awful. Man, you can’t take this life for granted. You never know when it’s gonna be over. It can be gone just like that.” I tut and look ahead as we get closer to the scene and it appears police have gotten there way ahead of us, having already secured the perimeter. Dispatch has let us know they cleared it for us, although the suspect fled. Don and I pull up to a house in one of the nicer neighborhoods of Philadelphia, right outside the Schuylkill. It’s about two in the morning and another unit has already arrived and is treating our female victim, which leaves us with the male.

As we’re coming out of the unit with our gear, I let dispatch know we’re on scene and check in with one of the officers who is there to ensure our safety.

“Is he awake?”

“Yeah, he’s awake.”

“What the hell happened?”

“Robbery.”

“Jesus.” Don says under his breath. I personally wouldn’t have brought Jesus into the conversation, but naturally, I had the same thoughts. After all, I live in a city where mayhem is like the sunshine, always right behind the next cloud. As soon as we enter, I see a man on the staircase, who barely looks 30, bleeding profusely from his chest. There’s a very thin line between life and death. Every second matters. The woman is not too far from him, a wound to the abdomen, and she looks dead. There’s a trail of blood leading all the way to the phone on the table across the room. I focus on my patient and immediately, I think collapsed lung.

“How old are you?” Don asks as we get him onto a stretcher.

“My daughter is upstairs.” The man panics.

“Your daughter?” I ask.

“I- I put her in her bedroom when I saw someone was trying to get in.” I look up the staircase and in the distance, I see a picture of the three of them at the top. He’s lifting a girl in his arms, and she looks quite young. They’re happy. And now he is bleeding out on the staircase and his wife is blue. If he has a chest cavity full of blood, we need to move. If it is not corrected and corrected soon, he will die. We send PD upstairs to get her out as we take him outside and get him into the ambulance. “Where is my daughter?” The words rasp out of him like air leaking from a tire, faint and wet at the edges.

“Don’t talk, just breathe.” Don warns him.

“Is my wife dead?” His voice breaks halfway through, each syllable pushed out between shallow gasps that barely move his chest.

“Caine, you wanna dart him?” Don asks me.

“I will. I’m sorry honey, deep breath.” I put a needle through the man’s chest and he groans in pain. “I know, I know. Your wife is being taken care of by the most qualified medics in the city.” I try to assure him. “And so are you. You gotta calm down and breathe, okay? That’s the best thing you can do for me now.”

“My daughter.” I feel for him so deeply, but all I can focus on right now is making sure he lives.

“The police are taking care of her, I promise.” I assure him. We may have bought him like five minutes, but now we have to leave. Don closes the truck and hops in the front. “We’re going to the hospital now, okay?” I tell him, but he looks so terrible and I can tell he’s not getting oxygen. “Are you still with me?”

When I have a patient and I know what’s wrong and what they need but I don’t have the tools to do it, yet so close to the people that do, it is my job to make sure they know to keep fighting.

“How old is your daughter, sir?” I ask him. Maybe if I remind him what he’s fighting for, he’ll have a reason to stay awake.

“Six.” Oh man… so young.

“Really?” I try not to let my emotions take over as I look at his vitals. I can’t show this man that I am scared. “I got my own that age. Marcus. What’s your daughter’s name?” I watch him float in and out. This is someone who wants to live. With his oxygen levels, the amount of blood he’s lost- In all my years of training, it’s rare you see someone stay holding on like this. He has to be able to see his kid again.

“Maya.” I can’t begin to imagine what this man is feeling right now. Someone broke into his home, the one place meant to be safe, and his wife is likely dead. He’s bleeding out, barely hanging on, and somewhere out there is a little girl who still thinks her parents will come tuck her in tonight. I’ve seen a lot in this city, but when there are kids involved, something in me just breaks. I can’t help but think of my two boys at home. They’re my heartbeat.

Motherhood changed everything. When my first son was born, it was like stepping into the world for the first time. Before that, I’d lived mostly in my head. Always thinking, replaying, preparing. But then he was there, and suddenly everything was real. I remember looking at him and thinking, Oh. There you are. When my second came along, it felt different, familiar. Like we’d already collided somewhere before, and I was simply finding him again. Those boys… they make me like the world a lot more than I used to. And that’s what terrifies me. Because the thought of being apart from them, of not being able to protect them in a moment like this, it’s the kind of groundbreaking fear that lives in your bones. And I wish I could provide this man with more, knowing that.

“That was a tough one…” Don reflects on our patient as we clean up.

“I know. Scary. You still good?” I gotta check in on my partner every once in a while after a hard job like that because he’s still quite new, even though he always has been calm, even around some of the scariest scenes. He’s only a few years younger than myself but I can’t help but feel like I need to take care of him. Perhaps I experience that duty to protect with everyone. Don joined EMS after he finished serving in the Marine Corps. Barely even 22, didn’t know what he was looking for. Maybe he just wanted direction. So used to being told exactly what to do, when to do it, how to do it. He needed a purpose. And now he’s about two years into the job and he hasn’t run away yet. I hope we have a keeper. I hope he found what he was looking for because he truly does belong here. But Don is destined for great things and he’s still just starting his life. He has so much ahead of him. He’s gonna go places, I can feel it. I’m 26 and I know technically I could say the same thing about myself, but we live such different lives. I became a mother to my firstborn, Julio, at 17, started training here when I was freshly 18. Now I’m married and a mother of two, and despite the fact that Vincent and I made some dumb decisions, I love him and my children more than I could ever love myself and I wouldn’t change a thing. I’m happy, really.

“I’m good, yeah. The fight in that guy was insane.” Don shakes his head.

“I know, man. Heart rate off the charts, cyanotic, blood pressure 40 over nada.”

“You think he made it?”

“Y’know, typically I wouldn’t think so, but he could’ve. I wonder if he’s related to Rasputin.”

“You just might be right on that.” Don lets out a chuckle. “You gonna check in and see if he made it?”

“Kinda scared to. I don’t know.”

“The truth heals.” he sighs and looks at his watch. “All that and it’s not even three. Still got…”

“Five more hours, hon. It’s not helpful to be counting down.”

“Yeah, I know. But I like to make Sophie breakfast in the morning. And I don’t want her to wake up before I get in.” he worries and I smile.

“You’re so cute.”

“I ain’t cute.” he tuts, but smiles, knowing damn well.

“I’m sorry, but clock watchin’ won’t do nothin’, you know that.”

“I’m just all nervous around her lately. I wanna make sure everything’s perfect.” He raises his eyebrows, having thought of an idea as he reaches into his pocket. “You’re a woman.”

“Thank you for that observation.”

“I need your opinion.” he says as he reaches for a folded up piece of paper. He flattens it out and shows me a picture of a ring. It’s beautiful. Expensive.

“Is this-”

“Mhm.” He rocks back and forth on his toes.

“Don!” I playfully hit him on the arm. “You didn’t tell me you were thinking of proposing!”

“That’s what I’m doing right now.” he laughs.

“This is so exciting. Don, I’m so excited for you; this is so great. Sophie’s gonna love the ring.”

“Yeah?”

“Of course.” The irony, huh. I just watched one young marriage end right before my eyes. And now I’m watching another come to bloom. It’s like a sign from the universe.

I finally arrive home after another ten hour shift. Since I work overnight, I only ever see my husband in the morning before I go to sleep and on the weekend for a few hours in the day. That’s if I’m not exhausted enough to sleep through it, but I try to wake up to see my kids. It’s not ideal, but we’ve been doing it for a few years now and we make it work. Those are just the things you have to sacrifice sometimes when you work a blue collar job and have children you need to take care of. The overnight shift is not one that I love to do, but that’s when our calls are most vital and that’s where I’m needed. I drop all of my bags and clothes onto the floor at the door. The dirty carpet is littered with children’s toys and the staticky television still has their cartoons playing from before school. Their plates from breakfast sit on the table and I pick them up, taking a bite out of the half finished toast left behind. In its own way, it’s paradise. Particularly if you’re a cockroach. I come upstairs to see my husband in the bathroom, leaning over the sink, shaving before he starts his day. Normal life. It’s comforting exactly because it’s dull and often pointless, and it slowly lulls us all into a state of waking slumber. It makes us fixate on foolish, meaningless moments like running out of shaving cream or ripping a shirt, as if these things were overwhelmingly significant. And all the while, the truly important events we are ignoring are sharpening their fangs and slinking up behind us. In the one or two brief moments of real insight we get in our lives, we may realize that we are being hypnotized by irrelevant trivia, and we may even wish for something exciting and different to come along to help us tune in and drive these silly, persistent trifles out of our heads. But now, here we are, Vincent about to start his day and I about to end mine.

“Good morning, Handsome.” I come into the bathroom from behind him and lean against his body. My head only comes to the top of his back. He’s not particularly large, but I’m a bit stocky myself, so we fit together well. He smirks and stops shaving to turn to me.

“Handsome you say? I like the sound of that, Mama.”

“How were the boys this morning?”

“Fine. Marcus still throwing his tantrums though when I try to cut off CatDog.”

“Yo, CatDog’s good shit.” I raise my eyebrows.

“It’s annoying when you gotta listen to it at seven in the morning.”

“Well, your seven in the morning is very different from mine.” I take off my glasses and leave them on the counter. “You done with the sink? I gotta shower.” I ask, despite the fact that he looks at me, disappointed with half a beard.

“Yes, Iris. I’m gonna go to work just like this.”

“I don’t see the problem with that.” He looks at me, deadpan. I slap his behind and sit on the toilet seat. “Hurry up; I’m tired.”

“So you gonna sit there and stare at me until I’m done?”

“No. I gotta clean up a little bit anyway. You could pick some trash up or somethin’, y’know.”

“Or something.” he mumbles and I roll my eyes. It’s sweet for only a little bit. Then there’s the bickering about the kids and the housework. There always is. Most of life is wishing, trying to get back to a memory of a memory you may have never had. This is what domesticated life looks like when you settle, huh? You do the dishes, you fold the laundry, you make dinner, you shower, you go to bed, repeat. Some of us run away by packing our bags and others run away by standing still for too long. But I’m happy. Really.

“Electric bill didn’t get paid, y’know.”

“I know… I’m gonna get on it today.”

“Okay.” I swallow. “But the money isn’t in our account so it had to go somewhere, right? You know anything about that?”

“Maybe we’re not makin’ what we thought.” he says as he looks into the mirror, shaving the remainder of his beard.

“No, I swear I worked overtime last week. My check looked right but it’s not in the bank. I gotta check in with my boss.” I say and he hums something. He’s not even listening to me. “I’ll just wash up tonight before work; it’s fine.” I get up and start to leave.

“And get all of that nasty shit from your shift on our sheets?”

“Well, you picked the minute that I came home from work to start shaving when you have all day.”

“I’ll be out in a minute, calm down.”

“I’m calm. I don’t care.” I don’t feel like doing this right now. Not today.

“You’re already bustin’ my balls for not cleaning up or some shit and now you’re rushin’ me out the bathroom.”

“I’m not rushing you.” I stand impatiently in the doorframe.

“You were. And I spent all morning arguing with these kids, crying over nothin’, had to drag them out of the house alone, and now I’m doing the first thing for myself today and you’re making me feel guilty for it.” Vincent argues.

“Jeez, sorry.” I throw my hands up in surrender. “Really. Sorry. I’m just tired.” I lean onto the arch of the wall, the plaster cool against my back.

“I know.” He rinses off his razor and throws it in the cabinet a little too hard. “Maybe if you were home a little more, you wouldn’t be so tired.”

“I’d love to be home a little more. But I can’t.”

“I just feel like if you were, we wouldn’t be fighting about all this small shit.” He closes the cabinet door, harder this time. “Y’know what? It doesn’t even matter.”

“What?”

“’Cause when you are here, you’re not actually here.” I blink, thrown.

“What the fuck does that mean?”

“I’m just saying. You’re like a million miles away. I never know where you are.”

“I go to work, I work my ass off for those kids, and then I come home. I always come right home.”

“You always come home,” he says, quieter now, “and then you pretend like you didn’t miss anything. And then you run around and try to fix shit, like the work I did while you were gone wasn’t good enough. It’s the last thing the boys need.”

“The boys are fine, Vincent. What are you talking about?”

“I’m not the reason they’re throwing tantrums in the morning. I’m here.”

“They throw tantrums because they’re little boys.” I snap. “Don’t start pointing your finger and making problems out of nothing because you’re bored. Of course you’re here. Where the fuck else would you be? You’ve always been here and you always will be. You know why? ’Cause you’re a goddamn mechanic. You have no idea what my life is like.”

“I work hard.”

“I know.” My voice cracks on it. “But you don’t work ten hours every night. You don’t watch people die. I just worked a call where I basically watched a little girl lose both of her parents in a robbery. It’s not the fucking same. So if you maybe gave me a little mercy-” I stop. The words hang there, thick as smoke. He looks at me, all that frustration still flickering behind his eyes, but underneath it- something else. Weariness. Fear, maybe.

The bathroom hums with the sound of the vent. For a second, neither of us moves. Then, he steps forward, slow, and presses a hand to the side of my face.

“I’m sorry.” he says, and it’s quiet. Not surrender, just soft. Human. “You’re right. I’m sorry.” I exhale against his chest, my forehead resting there as the fight drains out of me, leaving something fragile in its place.

“I’m sorry too…” My voice comes out small. “We’re both tired.” He nods, still holding me, and the two of us stand there in the bathroom light.

“I should have asked you how your shift was.” We do this a lot. This back and forth. “Let me start over. Tell me about your night.” I pick my head up, looking at him. I let myself relax for a second before responding.

“Got thrown up on twice.” I undo the zipper of my uniform.

“So as usual.”

“Yeah…” I don’t want to fight. I never do. “Had some of our regulars. Was in South Philly a lot, actually. We had this poor kid who did a few bumps of powder detergent.”

“A few bumps.” Vincent shakes his head and smirks.

“So this family I mentioned… Someone broke into their house, both parents shot. I’m pretty sure the mom was dead before we even got there and I think the father was a goner too after we sent him to the hospital. This little girl- oh my God, Vincent, they had a six year old kid, just like us, and she was all alone with the police. That’s terrifying.”

“That’s how old you were when you lost your parents.” he points out.

“Yeah…” I pray she doesn’t have to go through what I did. And for me, at least, I had Ezra. Having my brother with me for that experience gave me some sense of support and familiarity. “Poor kid. Poor guy. He was so worried about losing his family.” I hope he gets to lift her into the air again like the photo. I pray that he doesn’t need to lose his wife so young. I pray for a lot of my patients.

“I know it’s hard.” Vincent assures me. “Witnessing all that. Every night sounds so taxing.”

“I’m able to tune them out and move on to the next patient most of the time. That’s just the job.” As insensitive as it sounds, I don’t have the mental capacity to be emotionally involved with the majority of my patients. It can affect how I perform in my job. But there are those people every once in a while, those people that have life shattering stories and situations, and they get me. I’ve said before, I feel a lot. And for a long time, I trained myself to shove those emotions away. We work long shifts, and when a death happens a couple of hours in, you have to move on. You still have a whole shift to work, so you can’t let it impact you too much. You clean the truck, wipe the tears, and continue onto the next call. For my own sanity, I had to learn to be okay with death. I began to bring home the inability to show emotion and fully feel hardship. But I realized a form of heartache in itself is avoiding it at all costs. Now that I’m becoming more comfortable with myself and allowing myself to experience what it’s like to feel again, it’s not always good. It was ever since I had my kids that I started to open myself up again. I connect with my patients. My empathy makes me a better paramedic, but the heaviness that I come home with that I can’t leave at the door is an expensive price to pay. I love what I do, and I know I make a difference. My team and I are a family. I wouldn’t trade it for the world.

I am often haunted by some of my patients whom I lost. I don’t want to say it’s guilt. I know I do everything in my power to keep these people’s hearts beating. I am learning to feel less guilty about things that are out of my control. I know I can’t save everyone. But it’s just… It’s sad. And I feel terribly for them. The concept of death and loss is something that will always be hard for me to cope with. The things you see on the streets here, so many homeless youth and people who don’t have the resources to do better. Some people just need some help. And so many others out there don’t get it and look and these teenagers and 20-somethings on drugs or not doing themselves good and think that they’re degenerents. They think youth is wasted on the young. But suffering is inevitable and some experience it to a greater extent than others. Meeting it with compassion is our only way to grow. People always looked at my brother that way when he was having an episode. I’m not going to make a judgment on anyone. It’s so destructive, having people decide that you’re a lunatic, to brand you with their bullshit. I wish others could show a little bit of kindness, maybe. It’s pretty easy to stamp a person into the dirt when you know nothing. Any animal could do that. But to allow a man a chance to find some hope where there is none- that is real goodness.

“You never know.” Vincent says. “Maybe both of the parents lived and the kid is with them again already.”

“Yeah. Maybe.” I say, doubtfully, undoing my hair from the night. “Can you pay that bill today?”

“I’ll take care of it, relax. Ezra not harassing you yet?”

“He’s been good. He’s been on his meds. He hasn’t been distracting me lately.”

“Good. Let’s make sure it stays that way.”

“Leave him alone. He’s fine.” I defend him. He always brings my brother up, even when he’s not relevant, to distract me when I bring up a topic he doesn’t like. It doesn’t work, but I don’t have the energy to argue, so I let him believe it does. “I gotta get in the shower and then I’m crashing.”

“Okay. Love you.” My husband scratches my head, ruffling my hair a bit.

“You too.” I say easily. Too easily.