Stroke

When Ambulance 33 pulled up to a house a few blocks down from the fire station, Engine-Aerial 4 was parked out front, with three of its five crewmembers standing outside, including the officer on it, the captain of the station. When Kana walked up to the lieutenant, she asked him, “Do you need any more equipment from us? I’m an ELST, too.”

“I know that already, Hoshizora-san,” replied the captain of the paid crew with a smile, recognizing Kana. “We should be good with equipment. We really only need the stretcher from you guys. Let them know you’ll take over patient care when we load her up on the ambulance since you’re an ELST.” The badge on his uniform read his rank and his name: Captain Naofumi Kato.

“Got it,” replied Kana before she turned to her other two crewmembers and told them, “Get the stretcher ready and bring it in. I’ll go in and assist the medic” Kana then walked up the front door of the downstairs apartment and headed in, finding two of the paid firefighters assessing an older woman who was sitting on a chair in the kitchen.

Her face was drooping significantly and she was drooling a small amount from the mouth, both of them clear indications of a stroke. One of the paid firefighters said to her, “I think you really should go to the hospital, ma’am.”

“I mean,” said the older woman with somewhat of a slur to her voice. “It happened yesterday, and it went away with no problems.”

“And that’s exactly why you should go now,” replied the same firefighter as his partner was setting up a cardiac monitor and getting the electrodes in place. His tone of voice, though still calm and collected, gave off the impression that he was starting to get a bit frustrated. “Do me a favor and repeat this phrase, okay? ‘The frogs jump, three jumps, together jump, six jumps.’

“Oh, uh, sure, uh… The frogs ju-… Jump, three ju-“ The woman clearly had difficulty repeating the phrase, a tongue-twister in Japanese. Struggling to complete the phrase, she finally gave up and sighed, admitting, “Okay, yeah, maybe I can go.”

“Good choice,” replied the firefighter. He then turned to his partner and asked him, “Is the monitor set up yet?”

“Almost done,” he replied as he put the last electrode on the woman’s body and then put a blood pressure cuff on her right arm, the side unaffected by the stroke. As he did, he read a small pulse oximeter attached to a finger on her right hand and said, “Her O2 just dropped a bit. We should start her on oxygen.”

“I can do that,” then replied Kana as she walked over and reached into their medical bag to grab an oxygen tank and a non-rebreather mask. “Ma’am, do you prefer a mask or a nasal cannula?”

“Mask is fine,” replied the woman.

“Got it,” replied Kana before she carefully placed the non-rebreather over the woman’s head and then over her mouth before hooking it up to the oxygen tank and turning it on, flowing twelve liters of oxygen per minute. She then asked the paid firefighter-paramedic, “Do you want me to take care of the radio?”

“Yeah,” he replied before he handed the monitor to her. “Transmit the rhythm and call it in.”

Kana pressed two buttons to begin transmitting the woman’s heart rhythm to Yoshimatsu Medical Center, a large hospital located in the city that acted as a regional stroke, cardiac, burn, and trauma center, a one-stop shop of sorts that saw patients from both close to home and far away. Once the rhythm was transmitted, she grabbed her portable radio and tuned it to a frequency that would let her talk to the hospital. “Harukawa Fire Brigade Ambulance 33 to Yoshimatsu Medical Center.”

“Go ahead,” replied a doctor on the other end of the radio.

“We're transmitting a rhythm to you right now,” she began as she read the vitals of the patient on the monitor. “We have a seventy-four year old female with strong evidence of a stroke. She has facial and arm droop and is slurring her words. Her vitals are 130 for her heart rate, twenty-six for her breathing rate, and a blood pressure of 150 over 100. We are requesting permission for IV access and administration of medications via IV.”

“Permission granted,” replied the doctor. “I’ll advise medications when you are all set up. Begin IV access and rapid transport to the hospital.”

“Received,” Kana replied. As she did, the paid firefighter-paramedic was already preparing an IV kit and was feeling for a vein on the old woman’s right arm. Kana then got up and saw the other two volunteers bringing the stretcher into the apartment. “Bring it as close as you can. She won’t be able to walk very far.”

“Got it,” replied Daisuke as he got the stretcher ready by undoing the straps and lowering the rails on the side.

Meanwhile, the paid firefighter-paramedic told the old woman, “I’m gonna put a needle in you and start giving you fluids. You might feel a slight pinch, okay?” His partner, meanwhile, got a bag of saline ready.

Then, they heard another voice call out from the front door, the voice of an old man. “Is my wife in there?” Kana turned and saw the patient’s husband, who had gray hair and a balding head, walk in. “I was out for a bike ride when I saw the fire truck and the ambulance. I heard the fire brigade siren, but I didn’t think it would be for here.” He was clearly worried for his wife, although he was not panicking.

“We’re helping out your wife right now,” Kana told him. “We’re getting an IV started and we’re talking to the hospital right now.”

“Kaname-san,” then said Daisuke, recognizing the old man. “We’re doing everything we can.”

“I wish we were meeting under better circumstances,” replied the old man, feeling better seeing a firefighter he recognized. He then turned to his wife and told her, “I told you we should have gone to the hospital yesterday.”

“Wait, yesterday?”

Kana, confused, asked him, “What happened?”

The old woman, to the best of her ability, explained, “This happened yesterday during dinner, but uh… It went away. I thought this one would, too.”

“You didn’t tell us that when we asked you,” said the paid firefighter-paramedic to her. “All you said was you had a stroke in the past.”

“I’m sorry,” she replied. “I guess that’s why I… Well… I was reluctant to go today, but… This one hurts more.”

“Damn, I feel bad,” replied old man Kaname. “I should have just called you guys yesterday.”

“Don’t feel bad,” Kana assured him. “What matters now is that we’re here today and your wife is gonna get the best care possible.”

“I can give you a list of medications she takes,” he then said, looking to a cabinet nearby. “She doesn’t have any allergies, but I do.”

“I already got it,” replied the other paid firefighter, showing off the list of medications and allergies. “This has both you and her on it, right?”

“Yeah,” old man Kaname nodded. “Both of us. It’s got my allergies on it, too. I made it about a week ago, but I never thought we’d need it so soon.”

The paid firefighter-paramedic then told Kana, “I’m all set to start medications. Ask the doctor.”

“Got it,” she replied before radioing to the hospital again. “Harukawa Fire Brigade Ambulance 33 to Yoshimatsu Medical Center.”

“Go ahead,” replied the same doctor from before.

“Requesting permission to administer medication for the narrow complex tachycardia and the hypertension. Current vitals for the patient per the monitor are 136 for her heart rate, 27 for her breathing rate, and a blood pressure of 154 over 102.”

“Received. Do you know her approximate body weight?”

“Standby.” Kana then asked old man Kaname, “Do you know your wife’s body weight?”

“Fifty… Fifty kilograms,” replied the woman herself.

“Alright, that works.” Kana then radioed back, “Per the patient, she is fifty kilograms.”

“Received. Administer twelve and a half milligrams of Diltiazem over a period of two minutes via IV for the tachycardia, and administer nitroglycerin sublingually or with an IV for the hypertension.”

Kana repeated the instructions back, replying to the doctor with, “Received. Twelve and a half milligrams of Diltiazem over a period of two minutes via IV for the tachycardia, and nitroglycerin sublingually or with an IV for the hypertension.”

The doctor concluded with, “Received. I’ll put in a stroke alert for the hospital. We’ll advise where you’re going when you call back in to us.”

“We’ll use the spray,” said the paid firefighter-paramedic as his partner grabbed a small spray bottle with nitroglycerin in it and he grabbed a small vial of Diltiazem from a bag of medications.

“While you do that,” Kana said. “We’ll get the patient ready. I want her loaded up on the stretcher once the Diltiazem starts flowing.”

As the paid firefighters began to administer the aforementioned medication to the patient, Daisuke said to old man Kaname, “Your wife is lucky. Had we gotten here just a few minutes later, she’d probably be in a far worse state.”

“I went out for my morning bike ride like twenty minutes ago and she was fine,” the old man said with a sigh. “Shit, this day sucks.”

About two minutes later, the crew inside began to wheel the old woman out on the stretcher. As they did, Naofumi asked Kana, “Hoshizora-san, are you gonna take over on the ambulance or do you need the ELST on my crew to go with you?”

“I can take over,” she replied as they brought the woman to the ambulance and one of the paid firefighters opened the rear door. Daisuke then climbed up and pulled the stretcher in from the front as Kana loaded it up from the back. She then turned back around and told Naofumi, “You guys can go back in service. We’ll be all set. We’re going to Yoshimatsu Medical Center.”

“Perfect,” he replied with a thumbs-up. He then radioed out, “Engine-Aerial 4 to dispatch.”

“Go ahead,” replied a dispatcher.

“The patient’s been turned over to Ambulance 33 for transport to Yoshimatsu Medical Center. They have an ELST in their crew already. We’ll be back in service.”

“Received. You’re back in service at 0758 hours.”

“Ambulance 33 to dispatch,” then radioed Kana from outside the rig on her portable just before she jumped into the back.

“Go ahead.”

“We’ll be transporting one patient to Yoshimatsu Medical Center in Emergency Mode.”

“Received. 0800 hours.”

Kana then shut the door behind her in the back of the ambulance and told the driver, “Go in Emergency Mode. Tell me when we’re about five minutes out so I can call it in.”

…

Around 9:15 in the morning, Ambulance 33 backed into the station, having returned from the hospital. Kana got out of the back while carrying a clipboard with a paper on it, telling the other two crew members on the ambulance, “I’m gonna scan this PCR on the computer first. We’ll just rinse off the ambulance. No need to wash it.”

As she walked into the officer’s office, she saw Masako herself sitting down at her desk, which was next to Kana’s. “Oh, hey there.”

“You showed up late?”

“Yeah,” Masako replied. “I pulled into the parking lot just as the ambulance was leaving. How was it?”

“The old lady thought she didn’t need to go to the hospital at first,” Kana said, still in disbelief at how the old woman had acted. “I had to get her to say a tongue-twister before she finally agreed. She apparently had a stroke the day before, too, and yet she didn’t even bother to call 119.” She then sighed and put the patient care report, or PCR, through a scanner to upload it onto the computer. “I just got off of work, too. We got slammed at the West Yoshimatsu Fire Station.”

“I heard you guys had two auto-pedestrians back to back.”

“You’re God damn right we did. On the same block of course, too. One of them was messed up pretty good by some moron behind the wheel on his cellphone. The other broke his leg after some old lady passed out while driving.”

“Damn, that sucks for them.” Masako then closed out a file on her computer and said to Kana, “I’ve been having some more trouble at home. My son is getting impatient with my husband since he keeps coming home later and later, and I am, too. It’s getting to the point where we haven’t had sex in two whole months. It’s frustrating as Hell.” She then sighed as she arched her back on her chair. “It sucks since I really can’t leave for calls until he gets back from work or those dumb after-work parties he keeps going to.”

“Nine-to-five jobs were never my thing,” Kana replied to her. “That’s one of the reasons why I made firefighting a career. I get to work for a full day and night, and then for three days, I can do whatever the Hell I want.”

“I’m not saying I hate my job, to be fair,” Masako pointed out to her friend. “I like where I work at the village hall, even if it’s only part-time now. It’s just that I like to leave work at work and not make it my whole life, and the mayor respects that as he should. Unfortunately, my husband is locked in a job where his boss wants people there to focus a shit ton of their life on their job, and he can’t just quit and go somewhere else. That looks bad.”

“Yeah, that’s the big dilemma.” Kana then typed a few things in and submitted the PCR before clicking out of the program the fire brigade used to complete them. “By the way, are you gonna be at the Tanabata Festival on August 12th?”

“I hope so,” Masako sighed. “With everything going on, I don’t really know.”

“The chief wants as many hands as possible since he has something big planned for the demonstration we do for it this year,” Kana explained.

“How big?”

“Apparently, he had secured an old RV for us, and he wants to set it on fire so we can put it out.”

Masako exclaimed, “A whole fucking RV?!”

Kana then shushed her with, “Shhhh! It’s a surprise! No one else knows it yet outside of a few of the officers. They’ll only tell the rest of the brigade next week.”

“Oh, okay, sorry…”

“And yep, they’re gonna burn an entire RV. If all goes well, we’ll give the village a night to remember.”

“I hope so.”

Kana then got up from her seat, telling Masako, “I’m gonna go restock and rinse the ambulance. I was in the middle of the rig check when the call came in.”

As Kana left to go take care of the ambulance, Masako pulled out her phone and looked at the lock screen, which contained a photo of herself, her husband, and her eight year-old son. She then sighed and said to herself while shaking her head, “Where did we go wrong?”

…

At 10:30 in the morning, the Student Council for Harukawa Girl’s Academy began their special meeting. The school, a modest high school containing a few academic buildings and a dorm building, had about one hundred resident students and one hundred and twenty local students. Tomoko was one of nine students on the council, which had three students from each grade elected to it. She had been a member of the council for all three years of her time at the school, and had been elected to president at the start of her third year. As the rest of the council took their seats, Tomoko called the meeting to order. “Per the request of the school administration, this special meeting of the Harukawa Girls’ Academy Student Council is now called to order at 10:30 AM.”

As Tomoko looked over the papers before her, Vice President Keiko Yukimura, another third-year who bore dark blue hair and glasses, explained to the rest of the council, “On behalf of the President, I would like to apologize for the meeting being called on such short notice. While she was taking care of a small fire in the village, the school administration emailed her requesting us to call a meeting today.”

“And the purpose of this meeting has to do with the Harukawa Volunteer Fire Brigade’s program at our school,” Tomoko explained, somewhat dreading what she would soon have to say.

Everyone else in the student council room fell deathly silent. They knew based on Tomoko’s tone of voice that whatever this news was, it would not be good. Keiko, concerned about how Tomoko would feel while delivering the news, asked her, “President Morishima, do you want me to deliver the news?”

“No,” Tomoko insisted. “I can do it.” She then took a deep breath and began to deliver the bad news everyone had guessed was coming already. “There has been talk of discontinuing the Student Firefighter program due to the change in administration that occurred at the start of this school year. Our program, possibly the only one of its kind in Japan, has been in operation since it was put in place during the Second World War to help alleviate shortages in manpower due to many of the men being drafted into the military, and has contributed to the safety and well-being of people in the Village of Harukawa countless times. However, the new principal of the school feels that it places students who sign up to become volunteer firefighters at an unnecessarily high risk. Additionally, he also fears it could lead to a lawsuit due to the fact that the program is only open to students at our school and not to other high schoolers in Harukawa. He cited the Yaesu Ramen Shop Fire of 1993 as an example of how dangerous the program could be, and thinks we also don’t have enough training to do what we do. However, he has not made a decision yet to abolish it, and he says that if he does, he will let anyone still in it remain firefighters.”

The rest of the student council looked at her with expressions ranging from disbelief to despair. One member, a first-year, asked Tomoko, “President, what do you think of this proposal? Be honest.”

“If I was honest,” Tomoko replied. “I would end up saying some very profane and unprofessional things. I’d rather them not be recorded for the administration of this school to hear it. In the interest of remaining professional, I will keep my mouth shut. I wish to be cordial around the principal or when talking about him in front of others.”

Another member of the council, a second-year, then got up and went to a camera inside the meeting room, pressing pause on the device before telling Tomoko, “I turned it off. Be honest with us.”

Tomoko looked over and saw the rec recording light had turned off, indicating the second-year was telling the truth. “Are you sure you want to hear my honest opinion?”

“Yeah.”

Tomoko sighed, turning to Keiko and telling her, “What I say does not leave this room. We are to take this to our graves.” She then warned the rest of the council, “That goes for all of you. You’re all going to hear me say some very unladylike and rude things, but you wanted honesty, so I will give you my honest thoughts.”

“We won’t be offended,” Keiko assured her. “Go ahead, President Morishima.”

Tomoko took a deep breath to prepare herself before launching into an increasingly emotional tirade about the proposal. “I think the principal is a fucking asshole, and he has no idea what the Hell he’s doing by talking about this shit. What the Hell is he to say that we’re putting ourselves at too much risk or that we’re undertrained? I’d like to see his ass put a pack on and go inside a burning building if he’s got issues with us.” Everyone else in the student council room looked on in shock at hearing their president cuss so casually, especially about their own principal. “Just to put it into perspective, we currently have seven girls in the program including me, and all seven are either currently certified to use SCBA or are being trained to use it, which goes above the minimum requirements for volunteer firefighters in Japan. There are many fire brigades where most volunteers don’t even have that training, and even some who don’t have any fucking SCBAs at all. Out of the fifty volunteers in Harukawa, half have SCBA certification, and five of them are girls from this school. When a serious call comes in during the day, we often are some of the first people to show up since the school isn’t too far from the fire brigade’s station. This village needs us, God damn it!”

The rest of the council was still in shock at what Tomoko had said as she took a brief break to collect her thoughts, not expecting their normally calm and collected student council president to react so viscerally to the proposal. “Holy shit,” Keiko said under her breath.

With a hint of sadness in her voice along with anger, Tomoko then said as she slammed her fist on the table and got a bit louder, “And how fucking dare he use the death of one of our own! That’s a low God damn blow! I know people who had to see and hear Inami Tenko, a student of this school, burn to death in that ramen shop thirty years ago while trying to save its owner! She died a fucking hero, and no one can take that from her! I know her parents very well through my family, and I can tell you right now that they would be insulted and angry to hear their daughter’s name being used like this! I can’t even begin to describe how insulting this is to not just us student firefighters, but everyone in the Harukawa Volunteer Fire Brigade, including the names on that plaque outside of our brothers and sisters who gave their lives in the line of duty! If this asshole thinks he can shut the door behind Suwabe-san and my little sister, he’s got another God damn thing coming!”

When Tomoko finished her rant and took a deep breath to calm herself down, the same second-year from before asked her, “Do you want me to turn the camera back on, President?”

“Yeah, go ahead.” Tomoko sighed and remarked under her breath before the camera was turned back on, “This is some crazy shit…”

“The camera’s back on.”

“Thank you,” Tomoko then said as the second-year sat back down and the meeting officially began once again. “Okay, we shall now proceed with our council’s response to this proposal. Does anyone have anything they would like to say in regards to the proposal to abolish the Student Firefighter program?”

…

About twenty minutes later, as the student council left the meeting room, Tomoko and Keiko talked among themselves. “I’m sorry you had to see me act like that,” she apologized to the Vice President. “I’ve been holding that in since I read the proposal. I wanted to rip that paper up and throw it in the trash, but I held back.”

“You had to get it off your chest,” Keiko replied as they walked down the hallway together. “I understand. I knew you wouldn’t like it when you read it.”

“And it looks like the student council agrees with me, given we unanimously voted to oppose the proposal.” She then looked out at the village from the third floor of the school, sighing and telling Keiko, “I don’t know where I’d be if the program wasn’t here. I genuinely can’t picture myself not being a firefighter, Keiko-san. I don’t think I can really make it a career, but that’s okay. The proverbial bug bit me when I was a first-year, and it never let go. Every time that siren goes off, my pager rings for a call, or I get an email on my phone about a call, I get this rush of energy as I run to my bike or I even just run down the street to the firehouse. Whether it’s someone’s house burning down, someone who crashed their car, or someone who in some other way is probably having the worst day of their life, I just feel the need to help them.”

Keiko smiled. “You and your sister really do have big hearts.”

“I guess. Even so, though… There is another aspect of it.” Tomoko rested her arms on the windowsill as she explained. “Fire is addictive to me. I’m not one of those pyromaniac freaks who sets fires and jerks off to it, but I feel this rush when I put out fires. I feel great when I’m on a hose line or searching inside a building.”

“Are you gonna say it feels like having sex or something?” When Tomoko blushed and turned around, Keiko shrugged and replied, “What? That’s the first thing I thought of.”

Tomoko remarked, “I’m a virgin, so I don’t know what sex feels like, but when I do get around to it, I’ll let you know about that.” The two then shared a brief laugh before she felt her phone vibrate with a text. She then pulled it from under her school uniform shirt and checked it, seeing that it was from Ayumi Tamura, a second-year student firefighter and a member of the school’s swim team. She sighed, texted her back, and told Keiko, “I’ll be back. Ayumi-san says she lost her key to the pool and she needs to get let in.”

“Tamura-san?”

“Yep.” Tomoko then left, telling Keiko, “I’ll see you later.”

“I’ll have the student council’s letter to the principal composed and sent by tonight.”

“Perfect. Thank you.”

As Tomoko walked down the stairs to go to the school’s pool, Keiko said to herself, “I feel so bad for her and Rumiko-san. I can’t imagine how the others will feel when they get the news.”