Beside him, partially hidden under a sheet of patient labels and some IV supplies, is a single sheet of paper with some squiggly black lines that, to the learned and practiced eye, tell a different story. A distinctive pattern of elevation and depression. Certain waves are far higher and sharper than they should be.
His heart is choking, dying.
* * *
Fortunately, he did most everything right. He took aspirin. He came to a major hospital, with a cardiac catheterization laboratory capable of emergently imaging his heart, identifying blocked vessels, and reopening them to reperfuse his hypoxic myocardium.
Unfortunately, the cath lab is busy. A complex case on the table that cannot be interrupted. So the hospital makes phone calls, looking for an available lab, an open table. And a call to 911 as well, and four miles away I flip a righteous U-turn in ten thousand pounds of ambulance and fumble for the siren.
* * *
That brings us to now, standing in the room, reassuring this patient, making small talk, as the hospital works to transfer him.
The cardiologist comes back in. Good news. Mercy Medical Center will take him. They are calling in the team. Load and go.
We get him on our stretcher, all our wires and tubes in order, paperwork signed, report called, and then his father and son appear in the doorway.
The boy is maybe ten, and he looks worried, holding his grandfather's hand.
"It's okay," the man tells his son. "I'll be alright. Listen to grandpa. Remember it's bath night. I'll see you soon."
"I will," says the son, and my partner thumbs the button and the gurney rises with a hydraulic whine, high above the reach of a small boy, who is trying to hide the fact that his eyes are full of tears.
The gurney starts to move, and I take one step, two --
"Wait, wait," I say suddenly, surprising myself. I look down at the boy, full of thoughts of my daughters at home.
"You want to give your dad a hug and kiss?" I ask, and even before he's nodding, I've scooped him up, lifted him level with the gurney, so he can wrap his arms around his father's neck and peck him on the cheek.
Then I set him down, he scurries to grandpa, and we take dad off into the gathering dusk.
* * *
Five miles away and forty minutes later, I lean against the wall of the cath lab control room, watching the team work through the glass. They are fast, sure, professional, all precise movements and chopped, incomprehensible terminology.
A monitor plays black and white loops, a few seconds of flouroscope imagery at a time, as they probe his heart with wires and radiopaque dye.
There. An absence, a hole where a dark artery should be. They swap equipment, thread another wire, push the plunger on a syringe, and someone says, "There's your door to balloon."
On the flouroscope, a little elongated sausage shape appears briefly, then is gone.
The next flush of dye shows the missing artery, open again. Already the EKG is returning to normal.
"Did you need something?" the tech asks me.
"Nope. Not a thing at all. Thanks."