Sirens in the Night

Through these doors pass away some of the nicest people in the world. 

February 1975By Comments

There are voices in the siren. They drift back and forth from each other, an atonal choir trading off harmonies. There is the familiar droning voice that planes upward but at some imperceptible point sub­sides and starts over again, like a labora­tory wave that never crests. Then, over­laid on that, is a high pervasive wail that penetrates every hollow where sound can reach. Inside the ambulance there is an empty place, like the eye of a hurricane, where the sound does not penetrate. It is, in a sense, quiet there.

Captain D. E. Gunnels and I are casually swaying from our seatbelts, which are firmly anchored in the mod­ule section of an ambulance which at the moment has its siren turned up full blast. The module, a removable camper-like shell mounted on a one-ton Ford pickup chassis, is a treasure-trove of severe-looking gadgets, each severely in place: stretchers, respirators, spine boards, defibrillators, cabinets full of drugs and bandages, a bank of tele­phones and radios, and a very sophisti­cated machine about the size of a cheap fold-up stereo called (affectionately, since it saves 25 lives a month) a Tele-Care—a “complete heart-attack kit.”

Gunnels had been showing me around back at the fire station, explaining some of these gadgets, when a call came through for this very vehicle. So we fastened our seat belts and pulled out in mid-lecture.

Now, with the siren loose and the shadows jerking in through the windows every time we take a corner, Gunnels picks up where he left off, pointing out the components of the Tele-Care: os­cilloscope, EKG and blood-pressure measuring devices, oxygen masks, and devices for sending all this information instantly to the Ben Taub emergency room to be monitored and recorded.

Gunnels has the kind of tight-skinned good looks and wavy hair that seem at home in the comfortable-looking, well-tailored uniform of the Houston Fire Department. On his left sleeve is a patch with some quasi-medical symbol slither­ing over an outline of Texas that identi­fies him as an EMT, an Emergency Medical Technician.

The two men in the cab are also wear­ing that patch on their sleeves, though all I can see of them through the slit in the cab’s rear window are the backs of their heads, one blond and one dark, yinnish and yangish enough to bring to mind an observation of Faulkner’s I’ve recently happened across: “Apparently all the stretchers in the world must be propelled not by two physical bodies in accord but rather by two matched desires to be present and see what was going on.”

What is going on is this: the ambu­lance is very near now to the city jail where an inmate is reported sick. Gun­nels is still pointing out equipment as we pull up to the jail. The two men in front come out and reveal their faces, the blond one’s taut, the dark one’s a little slacker; both of them calm and pleasant.

Gunnels arranges me so that I am sandwiched behind the team and in front of him as we walk inside under the eyes of a series of especially beefy-looking guards. “He’s with us, he’s with us.” Gunnels smiles, sensing immediately what it takes me a moment to fix on: that it has been a long time since I’ve been clean-cut enough to be above sus­picion in a city jail.

“He does look like one of our custo­mers,” a heavily armed elevator operator says, with what I will write down here as joviality, though at the time there is not much humor in the air.

The stricken man is lying on the floor of a corrosion-tinted common cell, writhing in pain and surrounded by a semicircle of fellow inmates who stare at him listlessly.

A guard yells at them, shoves them back down a corridor to make room for the ambulance team. When they see me, some regard me with camaraderie, others with resentment, then they focus their attention on the two EMTs who have rushed smoothly over to the victim. The two men do not even look up at their surroundings: they are accustomed to passing easily and anonymously through any kind of crowd.

The dark-haired one, the one carrying the black medical bag, squats down be­side the victim. His name tag is now visible: J. W. McAnally. Initials instead of first names are standard issue for EMT name tags.

“Hey, man,” he asks, “what’s your name?”

“What’s your name, man?” his partner echoes. The name etched into his own tag is D. B. Little.

The man on the floor, who is wearing a T-shirt and Levis held together at the knee with a “Finger-lickin’ Good” patch, tethers in his consciousness from a wide orbit of incoherence and pain.

“C-c-cooper,” he says.

They lay him on the stretcher and we file out through those barred corridors that are already narrow beyond endur­ance. Little drives; McAnally, Gunnels, and I ride in back with Cooper, who still fidgets painfully on the stretcher.

It is a Code 1 run, the least serious gradation of emergency. And though the siren makes a low shallow sweep around it, the ambulance does not seem to be breaking pace with the rest of the traffic. Cooper’s problem could be a seizure of some kind, a bad fever, withdrawal symptoms, a lot of things. Gun­nels tells me later that his illness is borderline enough that the drivers could have refused to carry him.

“We have people who call us for nightmares. Sometimes old ladies call us to get a ride to the doctor.”

Cooper groans some more and holds his head, grinding out the word “ma­chinist” when McAnally asks him what he does for a living.

Gunnels then calmly begins reciting statistics for my benefit. In 1973, the second year that the City of Houston ran its own ambulance service under the aegis of the Fire Department, anywhere from 23 to 30 ambulances average close to 140 runs a day. That worked out to 50,289 for the year, and breaks down into this: 1500 false alarms, 6000 heart attacks, 1500 overdoses, 1500 obstetrics cases (“take it easy, Cooper, we’re al­most there”), 1600 cuttings (“knifings,” to us civilians), 1500 shootings, and 10,000 major accidents. There’s a $25 charge to the victim for an ambulance run, a sum the city actually manages to collect about half the time. All ambu­lance teams include EMTs who, be­sides being firemen, have at least 120 hours of medical training, an education that includes the delivery of a baby.

The emergency room at Ben Taub Hospital is generally regarded as one of the best in the country. Unless a patient specifies another hospital, the drivers routinely point the ambulance in that direction, where the Fire Department maintains an elaborate radio room for monitoring the patient’s, vital signs, which are transmitted from the ambu­lance.

Immediately after we arrive at Ben Taub, Cooper is swallowed up in the brisk efficiency of the emergency room. We wait around long enough for the EMTs to relay his symptoms to a group of doctors and technicians (who wouldn’t feel too comfortable in the city jail, either), fill out a few forms, and trade some semi-morbid gossip with staff members. But that’s as far as it goes: Phase II of their patient’s fate occurs in another arena.

We head back toward the main fire station, a brand new four-story building on Bagby Street, nestled up against a bend in the freeway. This is Fire Station No. 1—“ones” it is called for some reason—where Ambulance No. 1101 cools its wheels between runs.

Chief L. O. Martin, the director of the Houston Ambulance Service, has his office on the third floor of this build­ing: an office whose walls are covered with certificates of merit, testimonials, honorary memberships in organizations like the American Trauma Society and Troop 11 of the Boy Scouts.

Martin himself is a broad, solid man whose handshake reveals the prototype of those huge hands which seem to be standard issue on every fireman. One of those hands is always busy reaching for the telephone, the other more often than not is waving somebody (like some sub­ordinate with a salvage list from fast week’s submerged ambulance) into the room; then turning palm out to keep him from speaking while Martin is on the phone, then gesturing him forward again to leave the list on his desk; all of this causing the intruder to perform a staccato soft-shoe in front of Martin’s desk.

Every once in a while, in a brief in­terval between when he puts down the phone and it rings again, while the staff members and secretaries he’s been juggling are temporarily in suspension, he will turn to me and ask,

“Okay. What do you want to know?”

And before I can answer that I don’t want to know anything particularly, I just want to hang out with an ambulance team, the phone has rung again-—actual­ly a half-ring is all it can manage before he has pounced on it and is saying, long before the receiver has made it anywhere near his mouth, “Ambulancesection-martin!”

He is just about the most efficient, person I’ve ever seen. That efficiency may be what is at the root of a gruff charm not unlike that of crime bosses in fast-talking Thirties movies.

I see a chance. “I—”

But another torrent of facts is already heading my way. This time it is an abbreviated history of the present am­bulance system: how three years ago, after increasing citizen dissatisfaction with private ambulance service (in most places in Texas, all you need to be a licensed ambulance operator is a first-aid kit and a package of splints), the Harris County Medical Society re­searched other possibilities. It came up with a system modeled after the one in Jacksonville, Florida, where the city maintains an ambulance system operated by the fire department, which already has a number of strategically located stations around the city. The Houston Fire Department accepted the responsi­bility and proceeded to put together an ambulance system commensurate with Houston medical services in general, so that Houston is now arguably one of the best places in the country to be in­jured or deathly ill.

Houston not only has the finest ve­hicles and equipment, Martin contends, it also has the best personnel—he says that with their fireman’s training they all have 600 hours of instruction and three years of experience. There is a whole file of letters of thanks and commendations for individual EMTs from victims and their families.

But the day is wearing on and so far I’ve been on only one accidental and highly supervised ambulance run.

“Well, what I’d really like to do is ride around in an ambulance awhile.”

Martin swings forward in his swivel chair, skims his eyes across the scroll­work decorating the wall over my head, and says,

“Frankly, your appearance is going to be a problem.”

“Why is that going to be a problem, exactly?” I ask as calmly as possible.

That never becomes clear, exactly. First Martin implies that my “appear­ance” will cause bitterness among the well-groomed men at the fire station, who, for reasons that will be explored later, are already bitter enough. But then he seems to brush that reason aside in favor of another one: people may tend to associate me with the Houston Fire Department. I see nothing wrong in that. Well, see, my appearance, might disturb the victims I encounter because I don’t look “official” enough. This seems to be the reason Martin settles for. And at the time it almost seems valid. (I anticipate feeling ill at ease, if not genuinely creepy, looming around and taking notes in the faces of stricken people.)

But, as I discover later, this excuse is nonsense too: people in distress will ac­cept any creature that issues forth from an ambulance. It’s not hair on your face that they’re watching for; it’s some ex­pression of assurance, competence, im­portance.

But this obstacle, which has been re­defined as a lack of any discernible bed­side manner on my part, intrudes itself throughout the early parts of the after­noon. I’m taken on an interesting but issue-skirting side trip to the ambulance dispatch room where EMTs eat sand­wiches and say, “You’ll have to speak slower, ma’am, just calm down, ma’am,” into the telephone. Then a compromise solution surfaces in which I’m to ride around in a radio car with a fire captain in hopes of converging with an ambu­lance at the scene of an accident. But even the Fire Department senses that this is just voyeurism. There are some half-hearted suggestions that I wear a white labcoat if I still want to ride in an ambulance, then finally there are no more suggestions at all. The next morn­ing I get “assigned” to a team.

Yin and yang again. Ralph, “R. L. McPheters,” is the quiet one, with dark hair and dark eyes that are usually directed downward. He has a more or less constant nihilistic smirk, inflexible and possibly as inorganic as the smile on a crocodile, but for all their broodiness his features are gen­erous and open.

His partner is E. P. Christopher. A little further into his late twenties than Ralph, maybe into his thirties, Chris is the one who does the talking when the questions are up for grabs. He has a schematic resemblance to Ernest Borgnine, the same round face, the same big frame that is nevertheless quick and re­flexive in its movements. Chris is buoy­ant where Ralph is grave.

The territory of ambulance 1124 is a large chunk of the southeastern part of downtown Houston, mostly black and chicano and mostly edgy, whose streets, except for the big time arteries like Fan­nin and Dowling that run with them for a while, all seem to bear the same series of shabby houses, bars, liquor stores, and barbecue joints, a pattern as consistent as the images on a bolt of factory cloth.

Headquarters for the ambulance and its drivers is Fire Station No. 24, located almost like a colonial outpost in the heart of this district. There is a separate garage for the ambulance, with a kind of dorm room beside it in which the drivers fitfully try to catch up on their fitful sleep. (EMTs, and firemen in gen­eral, have schedules that correspond more closely to the phases of the moon than to a five-day work week; during the time they’re on duty, they’re on call day and night.) It is now mid-afternoon, mid-week. Normally that’s a slow time and today is no exception. I follow Ralph and Chris into the fire station where we sit around with the rest of the firemen and watch I Dream of Jeannie, then May­berry R.F.D.

And Martin was right about one thing: my presence is causing a just barely discernible tension among the regular firemen. These guys are indeed bitter. It seems they’ve been watching the EMTs cornering all the glory for three years now, watching the way they can cruise around all day in the ambu­lance if they want to, occasionally es­corting young ladies in the form of sen­ior nursing students, while the firemen themselves remain on call at the station mowing the lawn, standing watch, pick­ing up firehoses, or cleaning the big white fire truck.

And the letters of commendation, the waves of public adulation for the EMTs just keep rolling in past the noses of the regular firemen, the pikemen and chauf­feurs, who run a statistically higher risk of death, they’re eager to point out, than even the police, and who are paid less.

Their bitterness may be amplified by the fact that three years ago they them­selves had the opportunity, along with Chris and Ralph, to enter EMT candi­dacy. No doubt at that time it would have taken a remarkable degree of shrewdness to predict where the fringe- benefit chips would fall, since EMTs were not going to be paid any more than a regular chauffeur. Most just chose blindly and lived with the results.

Understand then that a reporter come to heap more publicity on EMTs is not the most welcome of visitors to this fire station.

“How much money do you make writing these articles? Hell, I bet you have to haul it to the bank in a wheel­barrow.”

Stuff like that.

But the bitterness is basically good-natured, and it soon collapses into a discussion of astrology, with Chris read­ing everybody’s horoscopes out of the morning paper.

“You’re a fish, aren’t you, Captain?” he asks.

“No, Mr. Christopher,” the Captain replies, polishing off his lunch of cherry strudel, cookies, and a Coke, “I’m a water-carrier or something.”

Just then the ambulance phone gives a loud, sharp ring, a little less drastic than the Ah-oogah! I’ve been bracing myself for. Ralph answers it and takes down an address from the dispatcher, enters it into a log, and we’re pulling out of the garage in about 30 seconds.

This time I’m riding in front and I can watch, a little apprehensively, a sea of cars stubbornly parting as the ambu­lance lurches around and through them, slowing almost to a stop at every inter­section and then picking up speed again. (Though not as much speed as you probably think—the policy is for the driver not to go more than ten miles above the legal speed limit.)

We arrive at an apartment complex with about two dozen closed doors and no indication of an apartment number from whoever requested the ambulance. Chris lets out a couple of siren blasts but no one comes out. He calls the dis­patcher and has them phone the caller back but hears no ringing in any of the apartments.

“That’s the biggest problem we have,” he says as he climbs back into the cab. “False alarms. Probably some kids up in one of those windows laughing at us right now.”

But as we pull away there is another call: this time a tractor-trailer accident on the expressway. It sounds grisly enough to cause me a little anxiety about the possible reappearance of the fried chicken I had for lunch. And when we arrive at the scene it does indeed look bad: a jack-knifed semi, its cab bent cleanly in on itself in a way that does not suggest much hope for the occu­pant. But accidents, like good illusion­ists, can suggest the miraculous: the driver stands ten or fifteen feet to the side, incredulous and unscathed, while a small crowd stands around him shak­ing their heads and reminding him what a lucky man he is.

“Yeah, that guy is lucky,” Chris says. We’re just, sort of cruising now, talking, killing time before heading over to the Ripley Health Clinic to demonstrate the ambulance to a group of kids for Red Cross Safety Week.

They don’t often encounter the kind of miracles we’ve just seen. Most of what they see is pretty grim: they see things like “eviscerations,” which means that somebody’s guts are hanging out; they see instant and lingering deaths, and long-undiscovered deaths where re­mains have to go into a bag. They see burnings, shootings, cuttings, heart at­tacks, seizures, overdoses.

“Some of it still gets you,” Ralph says, looking off out of the window. “Kids especially. If you’ve got children the same age all you can see is them lying there. We bust our ass for kids.”

If it is not particularly aesthetic work, neither is it particularly safe. Already this year one EMT has been wounded by a ricochet through the head of a woman who had chosen his entrance as her exit, so to speak. (Gallows humor runs high on an ambulance.) Chris himself, in coming to the aid of a gun­shot victim, has had occasion to look up into the barrel of a cocked .45, with a voice at the other end saying, “I shot him to die, mister!”

But when Chris and Ralph pull their ambulance onto the grounds of the Health Clinic and a hundred kids wear­ing “BE SAFE” buttons come running up to ask them for their autographs, it’s pointless to ask if, despite all that, they enjoy their jobs.

The kids run their hands in awe over the surface of the ambulance, fiddling with all the exterior knobs and latches, staring in confusion at the “AMBU­LANCE” spelled out backwards just over the headlights (written that way so drivers can read it correctly in their rear-view mirrors), and swarm violently inside when Chris opens the rear doors.

“How fast does this go?” one of them asks Ralph.

“About 500 miles per hour.”

“See any blood and guts?” Captain Gunnels cheerfully asks when we return to the main fire station. I’m standing there telling him about the two false alarms like a fisherman talking about a played-out stream when a call comes for 1124 over his phone. A girl has stopped breathing.

At that we begin running down a third-floor corridor. Chris turns to me near something that looks like a giant plumber’s friend with the suction end inverted and set into the floor.

“You ever slid a pole?”


“Well, looks like you’re going to learn,” he says and disappears through the floor.

And suddenly everything is clear: why in the world would anyone not want to be an ambulance driver when you can slide three floors down a fire-pole, run to the ambulance, turn on the siren, and haul-ass through downtown Houston, watching with grim nonchalance the cars pulling over for you, the citizens pausing to stare after you, even the dogs coming out to howl along with your siren; and to do this not in fun or pretense but in a desperate race to save a human life.

“How long can somebody not breathe before the brain is damaged?” I ask, shamelessly exhilarated.

“Six minutes,” Chris says, not casual­ly, not intensely either. He drives easily, with his arms loose at the elbows. In civilian life he probably has a doorknob on his steering wheel. Ralph navigates, partly from a highly detailed Houston street map.

“Here!” He points to a liquor store where a policeman has just begun to signal us over.

As we enter the store it becomes ap­parent that no one has stopped breath­ing. Instead there is an eighteen-year-old girl in the back room freaking out be­cause her fiancé has been running around on her.

A paunchy man with greasy hair at the counter stops Ralph before he goes back to see her.

“She’s hysterical, you know.”

Ralph nods curtly, sympathetically.

The girl’s wailing has no trouble pene­trating through the door which, I guess out of discretion, I decide not to enter. It is not like the crying of someone whose heart has been broken, more that of someone terrified by the violence of her own reaction.

“You want a Coke?” the cop asks me.

Er, thanks, but not really. A man in undersized, sweaty clothes comes through the door wearing a slimy smile brimming with the thrill of vicarious danger.

“You folks havin’ some trouble here?”

“Nope. None at all,” the man at the counter says. Then, under his breath after the man has left, “Damn ambu­lance chasers!”

Then they bring her out. Her name is Rose. She is clinging to Ralph, bent over with sobbing. A pale, wasted girl with a delicate borderline beauty that has probably been dismissed as plain­ness in most people’s eyes. She breaks off from Ralph for a second to embrace the man at the counter.

“Goodbye, Daddy. I love you. I love you!”

Just after Rose and a friend are safely inside the module with Ralph, Rose’s mother drives up in a state of hysteria. Chris, seeing that she will probably just set her daughter off again, tells her to ride up in front with us.

“Just calm down, ma’am,” he says, “or I can’t carry you.”

It is a long ride downtown to Saint Joseph’s Hospital, with Rose’s mother making the sign of the cross repeatedly, then looking out the window and down at her hands, and with Rose’s voice coming from the module, tinny and strident over the intercom: “Oh God, how could he do that to me less than a week before the wedding?”

“That girl would have tried to kill herself tonight,” Chris says after we un­load her.

We cruise around some more at dusk. Every once in a while Chris will point out a house or a street corner: “We made a wreck there once... We made a beating there last Friday.”

“Not much action tonight,” Ralph says. “Maybe you ought to come back some weekend night when there’s a full moon. That’s when things start to hap­pen.”

The moon is three-quarters full in a dirty, ominous sky when I return on a Friday evening two weeks later.

Chris has gone to Dallas with his family to see a drive-thru zoo, and a regular fireman, Wayne Walker, is fill­ing in, as much as a non-EMT can, by driving and assisting Ralph. Wayne has a mustache that droops an illegal half­-inch or so down to his jawline, and dark glasses that he wears even at night. Something about the broad archway of his shoulders suggests that he might spend some of his spare time in the fire­house lifting weights. Like Chris, he’s done a stretch in Viet Nam.

Wayne is relating the story of how somebody took a dislike to one of the drivers on last night’s shift and vowed to kill whoever was in the ambulance tonight. That would include Nicki Simp­son, a photographer carrying a vial of anti-nausea, and your nervous practitioner of the New Journalism, less than eager to record the first first-person death; not to mention Wayne, who dis­plays by way of protection a pocket knife that looks about as deadly as a baby spoon, and Ralph, who doesn’t seem to have much reaction. (The threat never materializes and all four princi­pals escape with their lives.)

Well, it looks like it might be another slow night. Fortunately, small ironies can sometimes keep a story afloat, and I rush to point out that Firehouse is on the tube when we walk inside the station to wait for a summons.

It comes during the first half-hour of the Laurence Olivier movie version of Sister Carrie. A sick call.

We arrive at a worn but pleasant chicano neighborhood filled with chil­dren who immediately occupy the front yard of the house we’ve pulled up to. Ralph, shifted by circumstance if not inclination to the focal point of the team, walks into the house carrying his black bag with glum efficiency. Wayne follows with a stretcher. A crowd of relatives disperse from the hallway that leads to the sick woman’s room.

She is lying on her bed, frightened, in some kind of pain. A large woman in her forties. Her husband speculates that it may be food poisoning. Ralph takes her blood pressure and finds it high. When they wheel her out, the group of kids outside contracts at first and then expands.

“Look,” one of them says, “she’s cry­ing.”

After she and a module-load of rela­tives are taken to the hospital there is another call, this one at 3704 McKin­ney. A heart attack, the dispatcher says, though by this time I’ve learned to be skeptical about what he says.

“Hell, it’s the railroad yard!” Wayne says when we reach the address. “This can’t be it.”

Ralph calls the dispatcher back. The dispatcher calls the caller back.

“That’ll be 3407 McKinney, 1124.”

“That happens all the damn time,” Wayne says as he turns the ambulance around. “People get so flustered when they call they can’t get anything straight.”

We walk into a room in a run-down boarding house where an old man, sil­houetted against the twilight in an open window, is in the act of rising from his bed and fastidiously fastening his pants as though he were expecting guests.

“What’s your problem?” Ralph asks him.

The old man has not yet turned to face us. His arms are as thin as bird bones.

“Can’t breathe,” he says.

“Have emphysema?”

“Only for the last 30 years.”

The scant semicircle of hair on his head forms a fuzzy corolla in the light of the window.

In the ambulance Ralph gives him oxygen. On the way to the hospital he makes an occasional comment about the weather, his voice high and pinched from under the oxygen mask.

After we have dropped him off Wayne looks out philosophically at an imaginary landscape. “They haven’t got much beer into them yet. Come about ten o’clock they’ll start drinkin’ that beer.”

Come about ten o’clock Laurence Olivier has finally hit the skids just as Jennifer Jones has become a star, and all that’s left to watch is the news, fea­turing a general-alarm fire in Galveston. That last call was several hours ago. A slow night for sure.

Ralph’s wife has come down to Hous­ton tonight to talk to me. They live in Cypress, an unincorporated suburb that does not benefit from Houston’s ambu­lance service. In fact, she maintains that the ambulance service for most of the rest of Harris County is abysmal. She has proof: a dispatcher’s log indicating that the drivers were out getting their driver’s licenses renewed when someone needed an ambulance, a copy of the Cypress phone book in which you have to look through the yellow pages to find any kind of emergency vehicle service.

Mary McPheters is a member of the emergency medical service committee of the Greater Houston Civic Council, a group that has been trying to formu­late an efficient suburban ambulance service, one that could tie in with Hous­ton’s to form a county-wide system. So far they have met strong opposition from the local private companies. Mary suggests they sabotaged the committee’s biggest organizational meeting by spreading rumors of violence.

“Since my husband’s been doing this I know what’s available,” she says, “and I want that for my children.”

It is one in the morning now, then two. Wayne and Ralph are asleep in the room off the garage, and I’m sit­ting alone on the fire truck doodling in my notebook. It has been a monu­mentally slow night—two sick calls. No hatchet murders, no highway carnage, no blood and guts at all. I keep asking myself why I feel I have to see that, and come to the conclusion that it is not a journalistic question but a personal one.

I’m about to give up when the phone starts bleating in the EMT room. When I enter, Ralph and Wayne are pulling on their pants, tucking in their shirts in semi-conscious urgency.

“What is it?”

“Shooting,” Ralph mutters.

The alleged shooting is at a Prince’s drive-in. Another ambulance, 1122, is pulling away as we drive up.

Inside the cab of a pick-up, sur­rounded by a loose cordon of police and bystanders, a man is lying on his back across the seat.

“Where are you shot?” Ralph asks.

But he’s not shot. He had been stand­ing between the door and cab of his truck when the guy who was shot lost control of his own pick-up and slammed into him broadside. There are three or four large-caliber bullet-holes in the other pick-up. Who shot the driver of that one is unclear.

The man’s shin is fractured under­neath his cowboy boot, and he is in deep pain from where the door has rammed his chest. Wayne puts a splint outside the boot, and they get him pain­fully onto a stretcher.

Inside the module we wait a long time before taking off. Ralph takes his blood pressure, puts on a set of head­phones and reports his vital signs to a doctor at Ben Taub. Then, following the doctor’s instructions, Ralph inserts an I/V needle into the man’s hand to give him lactate to keep him from going into shock. Only after he is somewhat stabilized does Ralph allow Wayne to pull out. The man is lean, blond, about 30. Whenever the ambulance hits a bump he feels it in his crushed chest.

“Oh god-damn.”

“Sorry,” Ralph says, “can’t help the bumps in the road.”

“I know. I shouldn’t have said any­thing. Oh, Je-zuzz!”

The man, whose name is Raymond, is making wild efforts at cordiality, try­ing to absorb the pain into something familiar.

I watch him, conjuring up an image in my mind of a gigantic accident pool where you take a number every day and wait your turn to be assigned to a stretcher like that one, with someone like Ralph holding down your shoulders against a rough stretch of road.

At three-thirty in the morning I shake the oversized hands of Ralph Mc­Pheters and Wayne Walker and climb into my own module, recalling a little advice from L. O. Martin:

“Tell you what. Shave your whiskers and shine your shoes and we’ll put you in the ambulance service.”

Tempting. Almost tempting enough.

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