13 Rockstar of medicine

There were a number of things I didn't like about my new job. And I experienced two of them right away. Namely, the uniform included a garish, high-visibility safety-yellow jacket with reflective white stripes. This was part of a standard uniform of any med-tech working emergency calls, and the requirements were set by the city so that medtechs and paramedics could be easily and quickly identified. On the plus side, it was made of a ballistic kevlar microwave and was supposedly bullet resistant. It also had a smart holoprojector in the back that was mainly used in mass casualty incidents to identify which medic was from which responding unit.

Oh, and I had to buy it, and it cost about fifty per cent more than it should have since there was no other place I could get it from but the city.

The second issue was that carrying firearms were strictly prohibited while working. This latter dictate was direct from the city, and it was a requirement of any company that had contracts to respond to 911 calls, but I had to admit that it made some sense. There was a tentative agreement, even amongst gangs, that ambulances that responded to 911 calls were off-limits; only the most depraved Scavs might attack an ambulance. Oh, and Maelstrom possibly, but usually only the cyberpsychos of the gang. That might have changed if it was possible that ambulances could be armed and be possible combatants themselves.

It did make me accelerate my plans to install the monowire on myself, just to give myself the option to defend myself if I ran into one of those types of people while working. I had the Kendachi implant in bits on my workbench at home, and although I didn't think I could add much to make it more dangerous -- it was already almost ultimately dangerous -- I had a number of ideas of how to conceal it.

I was reworking the wire slot to look indistinguishable from a personal link slot. I also thought I had a way to make the monoresistant ceramic finger inserts transparent. If so, I could include a layer of variable SmartPaint underneath that would allow me to match the colour of the inserts with my natural skin tone, which would do a lot to hide the fact that I had them.

I hadn't decapitated myself in over a week during my daily practice with the monowire in VR. However, I still averaged at least one minor to moderate injury per two-hour training session, which equated to almost six hours of subjective training every single night right before I went to sleep. I had begun being able to do a few tricks with it that were both impressive and horrifying if they weren't done against virtual opponents. In addition to the normal whips and strikes that the VR simulator demonstrated and taught, I had begun being able to semi-long distance lassos.

In the simulation last night, I had jumped down a single-story building amongst a group of enemies and lassoed one of the virtual mooks by the neck, decapitating him instantly, then shifted into a series of lightning-quick whips and slashes that put paid the other five goons. It was true that towards the end, I accidentally cut off my hand at the wrist when I botched grabbing the fast-moving monowire, but up until that, I seemed like some kind of ninja!

As I was finished getting dressed, an incoming call startled me. For a moment, I didn't recognise the name, but then I realised it was the Professor of epidemiology that I had met briefly at NCU, giving them what I thought was a well-researched letter and essay about the consequences of the potential move to kill all of the birds in the city limits, including historical examples from the People's Republic's Four Pests campaign against Eurasian sparrows.

I hadn't heard anything about it for weeks, so I figured it was just ignored. I picked up on the third ring and said, "Hebert."

"Ah, Miss Hebert. Hello. This is Professor Hidalgo. You met me briefly during my office hours several weeks ago, do you recall?" came the voice; the picture-in-picture in the lower right corner of my vision was a middle-aged man wearing an actual tweed jacket, complete with those little leather patches on the elbows.

One thing I had noticed about the world was that it was so far from 2011 that a lot of things that I would consider stereotypical, even to the extreme of becoming a cartoonish trope, had gone full circle and become retro-chic, or even stylish if usually modified in a neokitsch style. However, when I bought clothes, I usually stuck to the style that Alt-Taylor liked, which was a Militech-inspired militaristic style featuring dark colours, usually black or dark blues and with subdued and modest cuts.

It was the closest style of clothes that met my internal definition of "professional" and "modest", but it was definitely, almost definitionally, a Corpo style, such that I even got side eyes walking into the door whenever I came to work. Although NC Med Ambulance was a corporation, technically, it was really just a small company, and all the workers were working-class people. The image I was projecting didn't quite fit in, but I didn't know how to change that.

I answered him politely, wondering if this was actually about my letter, "Of course, sir. How can I help you, Dr Hidalgo?" I couldn't imagine what else it could be about. He was a bit too old to be asking me out on a date, after all.

"I had finally gotten around to reading the two letters you left with me, and after doing a bit of research, I think you are correct in your guess that this is seen as just a simple political bafflegab, something to rile up the proles as it were before the election in November. It is actually quite distressing, not only because I agree with your estimates on the likely consequences but more importantly, the people behind this are especially terrible and shouldn't be voted into office!" came his agitated and slightly distressed voice.

Some of the words that were commonplace perplexed me, but I guess I could realise what the composite word 'bafflegab' could mean from context and its constituent elements. And I realised I was completely stupid when I approached this Professor. Of course, someone as highly placed as a university professor would have overriding political opinions or, more likely political opinions of the corporations that funded his research grants. It was a mere chance that his political opinions lined up with the goals I had. I wanted the people campaigning to kill the birds to stop, and he didn't like those people. How stupid I was that I assumed his academic or professional ethics would override pragmatism.

Still, I'd accept luck when it came my way. The way he was talking to me was superior to a slightly inferior, but he was talking to me as if I was in a similar peer caste as he was, i.e. referring to the voters as a whole as proles. I wondered if that was because I wrote a really well-researched paper both about epidemiology and historical matters from over one hundred years ago -- that was a pretty arcane intersection of academic interests for a teenager. He might suspect me of being some kind of power progeny, and if not, he at least considered me highly educated.

I was glad that I had my call settings configured to crop only my face in the call. He might have been surprised to see me in the garb of a meagre city worker, "Of course. I'm quite concerned, although I have to admit my interests are mainly so that I don't have to buy drums of DDT to dip myself in a few years when the mosquito population surges beyond all control, rather than the obvious political implications. How can I help you? Do you need anything from me to push this forward?"

He chuckled, thinking incorrectly that I was joking. "Yes, the letter you sent said that we could use the subsequent essay you wrote however we wanted. I'm just calling so that we can nail down some particulars regarding that. I appreciate your offer to gift it to me, but obviously, University policy would prohibit that."

I blinked a little bit and was a little surprised that he cared about university policy. I didn't care if I got credit for the essay I wrote. I made a non-committal sound to give myself a moment to think, and then I said, "Well, I wouldn't mind if you attributed yourself as the only author at all, but if that wasn't possible... then perhaps you could list me as second... no, probably the third author. I assume you will have to coordinate with someone from the History faculty, too, unless you have a particular personal interest in the subject of 20th-century Chinese history. There's no real need to forward any edits to me, either, unless you change the entire thrust of the essay."

His face brightened immediately, and I realised I had scored. He might have been ethical enough not to completely steal my work, but that didn't mean he didn't actually want to steal it, just that he wanted to do it in a way that followed procedure. Being the first author on a paper was the only thing his fellow academics looked at anyway, and I imagined he would use the slave labour of some History faculty grad student as the second author and list me as third just to satisfy propriety. "That's splendid, Miss Hebert! That's precisely what I was going to suggest; I'm so glad that we're on the same page now. I don't think there will be significant edits, and I think this will be published soon; some of my friends in the City Council will then try to use it to smash these idiots' hands in the cookie jar, so to speak. I have every belief this will blow up in their faces."

I nodded. I didn't care about all that. I didn't want to be eaten up by mosquitoes. And I didn't want Mr Pigpeg and his girlfriend to be shot. They had set up a nest near my window at home and usually bothered me for food most mornings. The little shit was quite demanding now. Still, I said, "That sounds great, Professor. If you ever need any help from me on the matter or anything else, please give me a call or mail. I realise that you're acting out of your own self-interest too, but I still consider that I owe you one."

He paused at that and then, after a moment, nodded, "I was going to say the same to you because this will make me look smarter than I actually am with my political friends. But very well, let us both carry this favour on our books going forward."

With that, we both disconnected, and I walked over to meet the two people I would be working with today and for a couple of weeks.

The way training for a new clinician at an ambulance company worked was pretty universal. You had a week or two of classroom instruction where you learned the procedures, and the specific patient care guidelines that the company had promulgated, which I had thankfully already completed.

This was my first day actually "on the job," so to speak, but they didn't just throw you into an ambulance and tell you to get to it. For a couple of weeks, you had to be what was called a "third rider", where you just shadowed an existing and experience two-person ambulance team. Generally, third riders would do the work and charting, or medical documentation, as if they were working normally while supervised by a preceptor, which was a more experienced med-tech or a paramedic. In my case, my preceptor was the same man who had hired me, one of the line supervisors.

That didn't surprise me because I was hired as a paramedic, was only sixteen years old, and had no work experience. Most of the med-techs working for this company were only technically EMTs. Actual certified paramedics would be in charge of any of the units they were put in, as there was no way that the short-staffed company would run double paramedics on a single truck. So since I was both young and inexperienced and a paramedic, I expected to be put through the wringer a little bit during my third rider stage, but it was fine as I could cope. I also expected I would get one of the more steady medtechs as my partner when I finished third riding as well.

Thinking of the fact that my birthday passed a little while ago, mostly unremarked, made me a little homesick. I wondered what my dad was doing and hoped that he was happy.

"Taylor! Over here, we're about to go look at the truck we're assigned today," called out the lanky man who did my initial interview. His name was James Burt, but he preferred to be called Jim.

I glanced over and saw him with a brunette-haired woman in her mid-thirties. Jim introduced us, "Taylor, this is Theresa West. Theresa, this is Taylor Hebert; she'll be third riding with us for a while." We shook hands, exchanged pleasantries and then went to the motor pool to pick up our ambulance.

Both of them walked me through the correct procedures; you had to carefully inspect the ambulance for any damage as if you were picking up a rental car because if there was damage that you didn't notice after you signed for the truck, then you fucking did it as far as they were concerned.

Then we had to carefully catalogue all of our supplies, consumables and drugs, making sure we were fully outfitted. We tested all of our equipment and inventoried our consumables. The drugs were separated into one large container that reminded me of a fishing tackle box that carried all of the normal drugs one would use for emergency calls and a much smaller box that we had to sign out from an armoured vending machine that contained all of our narcotics. Usually, the paramedic of the team carried these as they were technically the ones responsible for them as basic and intermediate EMTs could not administer narcotics unsupervised, so Jim handed me the small box after we carefully inventoried the three dozen or so small vials inside.

The narcs we carried were a synthetic opiate that made fentanyl seem mild for pain, actual fentanyl, about four different types of anxiolytic medications, and a lot of ketamine. Apparently, it was used both as an analgesic and partly as a sedative. The slang was to "drop someone in the K-hole."

I placed it inside my jacket, in one of the interior pockets that seemed as though it was explicitly sized for it. Perhaps it was.

---xxxxxx---

It didn't take long at all for our first call, and it was a doozy. We were all hooked into the city police net through our implants, although there was an actual encrypted radio unit in the ambulance as well.

*bzzt* The glyph highlighted in my vision indicated it was a police officer speaking, and the pointer indicated it was up ahead and relatively close, "10-45, here. We're going to have to get this highway shut down. Confirmed MVC involving a bus, 37 people onboard. Looks like bus versus a MaiMai; the driver of the MaiMai confirmed DOA. Secondary collisions, get a few units up here, please, Dispatch."

Theresa was in the back of the unit, audibly snoring, and Jim, while driving, smacked the partition that separated the back of the ambulance from the cab and yelled, "Alright, wake up. It looks like we will probably have a call. Taylor, go ahead and check the nearby vehicles, then switch on code 3."

I had already fired up the ambulance's scanner, checking the registry of any nearby vehicles, and I turned to him, "Should we wait until Dispatch calls us?" Although I asked him, I immediately clicked on the lights and sirens as soon as I determined nobody of import was driving nearby.

"Nah... we're so close it's almost impossible we don't get toned out for this," he said with the drawl of someone who had seen and done it all.

Sure enough, barely ten seconds later, an impossible-to-ignore klaxon briefly played in each of our heads before the voice of our Dispatch came on the line, "Unit 88, MVC on loop 210 in Santo Domino, northbound. Bus, 37 occupants, other possible involved vehicles, unknown injuries. NCPD on scene. Respond."

Jim glanced at me as he easily wove around traffic, half of which didn't even bother to pull over for our lights and sirens, and asked, "You wanna?"

I blushed but nodded and grabbed the radio handset on the dash, and pressed the push-to-talk. I could have done this in my implant, but it was cooler to use the handset, "Dispatch, Unit 88, responding. ETA zero three minutes. We're almost already there."

I placed the handset back on the dash and said, "Hopefully, this isn't a mass casualty incident." That caused Jim to snort.

"You heard the police scanner; it was a MaiMai. I bet the bus crunched it like a Nicola can. Probably then got rear-ended by the cars behind it. I bet only a few of the people on the bus are injured," said the more experienced paramedic. But then he paused, "But if it is, I will take one patient, and you and Theresa can stabilise another."

I nodded and then looked up ahead to see a huge traffic backlog, but a few NCPD patrol cars had already opened up a small path so that we could drive right up to the scene of the accident. I got on the radio to report that we were on scene, but right before I was going to get out of the ambulance, another different klaxon played in my head, and we received the following radio alert, "Unit 88, Dispatch, be advised Trauma Team is responding to collect their client, NC 17728192 Anders Weber. They are zero six minutes out, redirect and stabilise their patient, then proceed to the bus after patient hand-over."

Jim held a hand up, and he responded himself, "Dispatch, Unit 88, roger. Deets on the TT client's vehicle or condition?" But I had already zeroed in on a sports car that had rear-ended the bus and elbowed Jim and nodded in that direction. He chuckled and nodded, "Nice catch, newbie. Let's hurry. I always love when we get there before TT, plus the company loves it because TT pays us triple rates when we respond to their clients, even if it is only for a few minutes."

I grabbed the cardiac monitor and the bag with most of our commonly used equipment while Jim was carrying the bag with our drugs, and Theresa had the ventilator unit, just in case. I scanned the man that was sitting next to the crunched-up sports car; he was bleeding freely from a few lacerations on his head and neck, and his arm, an obviously cybernetic limb, seemed to be seriously damaged.

Jim took a look at his minor injuries and shrugged, and said, "You can take care of him. We can leave the field bag here for now, and Theresa and I will check the bus. Be real chill with TT when they get here; they're good chooms but take their jobs pretty serious-like." I nodded at him and handed over the vital monitor/defibrillator to him.

I scanned his face real quick to verify it was actually Anders Weber before kneeling down and saying in my best professional healthcare worker voice, "Mr Weber? How are you doing? Let me take a look at you if you don't mind. I'm a paramedic."

He glanced at me, seeming a little out of it, "Oh.. huh.. isn't Trauma Team...?"

I nodded at him and said, "They should be here in a few minutes, but we were just down the road and actually got here first, for once."

That caused him to chuckle, "Well... my tax dollars at work, I guess. Go ahead." I wanted to tell him that emergency medical services were privatised in Night City, although a lot of people didn't realise it since all the medics dressed the same, all the ambulances had a similar paint job, et cetera.

I plugged my personal link through the firewall, which was actually legal for me to own now that I was a first responder, into his interface socket as I diagnosed both his injuries, got a readout of his installed cyberware, and a report from his medical biomonitor. I went through a neurological assessment with him while simultaneously perusing his internal biomonitor. He had an older version that didn't include a direct link to a medical provider, so that meant that Trauma Team didn't have his vitals.

Almost on cue, a beep in my mind preceded another radio transmission, "NC Med 88, this Trauma Team Flight 4, we are two minutes out. Do you have a patient report?"

I fiddled with my internal controls, not used to the particulars of this company-provided software, before I figured out how to respond to them, then mentally held down the radio talk button, "Trauma Team 4, 88, your subscriber has two minor scalp lacs, one minor lac to the neck, scoring B on the SACE, vitals from his biom are pulse of 144, bp of 165 over 94, nothing interesting on the tox report, his left superior has severe damage, its a DK-MT-201 by Arasaka. I was going to disconnect it from its power cell, as it keeps trying to deploy the blade, and I don't want it to poke me, but I can wait if you want."

I had already started to clean and apply bandages to his neck and scalp, carefully avoiding the malfunctioning arm that contained a mantis blade and keeping it inside its reach in case it malfunctioned and deployed the blade on me. The SACE was the Standard Acute Concussion Evaluation, and although a B sounded like a good score, it meant that there was definitely a concussion and, therefore, at least a minor brain injury going on here. He couldn't remember precisely what day it was; he thought it was yesterday. But it didn't seem too severe; he was mostly alert, aware and had a non-altered mental state other than that.

He also said he was only a five out of ten for pain, which impressed Taylor because, to her, it looked like it hurt a lot more than that.

Trauma Team got back to me rapidly, "Roger that. Yeah, go ahead and disable that arm if you don't mind. We appreciate not getting geeked by our own patients, too. Also, if you could start an IV and administer 1mg of lorazepam, and a standard dose of whatever opiate you have, see if we can get that blood pressure down a bit. We'll have to land on the other side of the highway, but we should be there soon."

"Mr Anders, Trauma Team is almost here. I'm going to start an IV, and they've directed me to administer something for the pain; they should be here soon," I told the man. It was always best practice to tell a patient that was more or less alert what you were going to do to them, then do it, then tell them again what you just did to them.

I grabbed a small IV kit from the field bag, not bothering to move at the unnatural slow motion I usually did, which startled the man for a moment before I reassured him and started the IV, then pushed the benzo and opiate, followed by a flush of saline down the line. "Mr Anders, please, if you can, hold out your left arm. Your DK-MT has been significantly damaged, and I need to disable it briefly for the safety of everyone involved." He obeyed, and I let my medical sense and what I had researched about arm cybernetics guide me to an access panel, which I flipped open before carefully wiggling a power connector out of its position, managing to yank it free, which caused the whole limb to power down, and stop making those terrible grinding and sparking noises.

I heard the AV overhead, and it landed on the other side of the highway, briefly shutting down traffic going the other direction before four armoured people hopped out and double-timed it, hopping over the median and jogging over to me. The Security Specialists were scanning everyone and everything, and while they didn't have their small carbines pointed in my direction, they did have them held at a sort of ready port arms position, cradled in their arms where they could be deployed in an instant.

I took a step back, disconnecting from his interface socket, "Here's your guy. One milligram of Ativan was administered, and fifty mikes of fent. His pulse is down to 124, and his blood pressure has dropped thirty, both systolic and diastolic. Pulled the main power bus on his mantis blades, so they're in safe mode."

The two Trauma Team medics were easily spotted as they carried quite a bit of gear and only had a pistol in a holster on their thighs. One of them said, "Nice. Thanks. We got it from here; I'm sure they diverted you; go ahead and check the bus now," while the other deployed a portable gurney.

I nodded and waved before turning around and grabbing the field bag, and heading over to my two colleagues. I could hear another siren in the distance, which I assumed was at least one more ambulance responding to this crash.

Jim saw me coming over and said, "Awesome, I was just about to come over and steal the narcs. Get fifty of fentanyl and twenty of ketamine ready for Theresa's patient. Then come help me with this one; I think we might have to RSI."

I frowned and drew up the requested medication. I was a little upset now. These two from the bus were obviously much more injured, yet I had to waste time with someone that barely had a concussion. I sighed, I realised things like that would happen, and there wasn't really anything I could do about it. Perhaps when I took over the world, I could make it more egalitarian, but now I would just save those who I could.

I walked over to Jim's patient, and he reported that the man had a moderate to severe head injury and, through the mechanism of injury, was going to be directly transferred to the trauma centre in Watson. They were actually breaking regs by splitting themselves up and treating two patients at a time when one was seriously injured, but I assumed it was our second ambulance en route, and if so, it would save a little time if both of the package work was done ahead of time. It wasn't something she would have decided to do. Still, she could see how a very experienced paramedic would make that decision, especially if they expected me to return imminently, so she felt it was fine.

RSI was an acronym for "rapid sequence intubation," and it was one of the foundational "special skills" of a paramedic. If you stopped breathing or looked like you were about to stop breathing, well, we had ventilators to breathe for you.

Jim glanced at me and said, "Alright, we'll do this..."

---xxxxxx---

While we didn't get back-to-back calls all day, thankfully, that first call took quite a bit of time. It wasn't even the most seriously injured patient we got that day, as that went for the last call of the day, where we responded back to Arroyo.

*bzzt* "Unit 88, Dispatch, respond to the 2000 block of Jefferson street, Arroyo, the Fat Burger restaurant. Reportedly a man, who was pistol-whipping his friend..."--

Jim interrupted the radio transmission with, "As one does," to which I nodded ruefully.

"--apparently shot himself in the chest. He's unresponsive. NCPD on scene. Respond."

That caused Jim to tsk tsk with his finger while driving and shake his head, "Poor trigger discipline, choom. Alright, newb, hit it. Time for the rockstars of medicine to roll out."

Personally, I felt that was a case of instant karma, but I suppose we still had to save the lives of assholes, too.