Fight to the Core

Happy First Anniversary, my Love 

We just got here. Maybe two hours ago,” I explain. It feels good to talk. “We drove down here with the top down on the car.” As I tell the story I begin to realize the woman could be right. Sam returns with water and we urge Jim to drink.


We had coffee with breakfast, then tea on the way down. We unpacked and sat down and had three vodka and cranberries.”


I encourage Jim to keep drinking water and look around expecting to see an ambulance or at least a golf cart to show up; someone with a blood pressure cuff, some oxygen, one of those portable heart shocking machines.


Help is one the way,” the woman assures me. I don’t understand the sweat. Why would he sweat like that if he was dehydrated? I never take my eyes off him. He does not seem to be getting much better. I want him to drink more water, but he just keeps staring at the ground.


Honey just a bit more.” He takes a sip. The water going in is not equaling what is coming out.


I remember something about how sweating cools the body through evaporation. But I realize this response is actually making it worse – draining his body of the fluid his heart needs to carry oxygen through his blood. If we don’t get fluid in him fast. Shock is next. They tell me to drink water too, and I take a few sips.


After what seems forever, I see a truck pull up the hill from the Kerrtree Store. A man gets out quickly and jogs over. He seems to be the one in charge as I note a stethoscope around his neck and a Walkie Talkie on his shoulder. I am not much impressed. Where is the fucking ambulance?


The man introduces himself as John. “How are you feeling?” he asks Jim. I know not to answer. He is trying to get a feel for Jim’s frame of mind. Jim starts talking and after I think Jim has talked enough to show the man he is not well - I start at the beginning.


I note the extreme sweating and pale color. I need the man to know we have not been out here all day sweating and drinking beer. I need him to know this came on fast, in the cool late evening. I am still not sold on heat exhaustion, and I don’t want them over looking something important by rushing to judgment.


I recite the exact details of how we got to this moment. John is eyeing Jim, and his gaze settles on Jim’s drenched clothing. He asks me how long this has been going on. I say about 15 minutes, and remind him Jim has high blood pressure.


Yeah, his color is bad.”


The woman gives John Jim’s vitals again, which I don’t understand exactly. I can’t remember what a normal blood pressure should be, and I don’t want to ask and cause Jim alarm.


His heart rate is very high” she says to me. I already know the pale color and fainting means his blood pressure is low and that makes immediate sense to me. The heart has to beat faster to move blood through the body when blood pressure and/or volume is too low. Jim is turning blue because what blood he has is being pushed to his vital organs. I feel the panic creeping back and the threat of shock is swirling in my gut.


The man in charge pulls out a small device and attaches it to the end of Jim’s finger. “Blood oxygen is 98. That’s very good,” he says and I smile. I hold my hand out and ask him to take mine. He attaches it to my finger and seems alarmed, “Her heart rate is twice yours!” Jim and everyone let out a small laugh to produce a bit of a tension relieving moment. We all know it’s the adrenaline. “I feel fine,” I say with a look to remind them who the patient is.


John listens to Jim’s heart with the stethoscope and says he wants to compare a sitting and recumbent heart rate. He explains this can tell if the high heart rate has to do with some real heart problem or simply dehydration. I grab the blanket we brought along and fold it under Jim’s head as he leans back.


With Jim on the ground I can see his face better. I realize he is really really not good. The situation does not seem to be getting better. He is beyond clammy and white, even his ears and hands and arms are grey. His eyes are dark and his lips completely blue. He just doesn’t look like my Jim at all.


Honey everything is going to be fine.” I don’t know if I believe that, but I won’t let myself believe anything else. “They are on their way,” I assure him. Jim nods and smiles a slight smile I know is only for my benefit. I lean close and he raises his head to inch up to meet my kiss. As our mouths meet, my heart sinks and a sob bursts into my chest. His lips are like ice. It’s fucking 90 degrees out and his lips are like ice. I resist the urge to pull my mouth away, and I hang there on the chill. I hope he does not sense my terror.


He lets go, and I scan his face. This is what Jim would look like dead. If his eyes were closed and his chest was still, this would be it. For a moment it is June and I am in Houston standing over his uncle Wilce’s coffin. The family resemblance had stolen my breath and I’d had to turn away. Now I can see Wilce’s shell in Jim’s face, and I feel helpless.


John finishes with the heart rate test and tells Jim to remain down. I notice right away that John does not tell me the results of the test. He does not confirm its dehydration and this raises my concern. Jim’s legs have started shaking. He’s not sweating so much anymore. I stroke his forehead telling him for the hundredth time I love him.


Let’s call it,” the man says. His helper nods.


You’re calling an ambulance?” I ask dumbfounded that one is not already on the way. I had assumed that was the first thing they had done.


Yea, with his heart rate and history of hypertension,” the man stops mid sentence to take the call on his shoulder. “Yes 43 year old male, history of hypertension, he is …..”


Off call,” the woman shouts. I realize she is telling the man to walk away, shut up or talk code so I won’t understand what he is saying about my husband.


The man returns. “They’re on the way.”


Shouldn’t he drink more water,” I ask.


No,” he says. “When EMS is called they don’t like us to give them anything that could cause complications.”


Logic tells me to prepare myself. That at any moment they could be on top of Jim, pounding his chest; each second he takes a breath and blinks up at me is like Christmas morning.


I look out toward the Kerrtree Store and realize it’s almost dark. All the colors have faded into a dark purple sky. I can only hear the night’s creatures buzzing. I have been listening for sirens that have yet to sound. They must still be a long way off.


Finally I hear the rumbling of the truck and realize the ambulance is approaching. They never ran the sirens. I should realize this is good, but it only makes me feel like they don’t understand how critical the situation is.


The EMT runs up and John helps Jim sit up. While retaking his pulse, the EMT gives him a look over and asks all the same questions again. I notice Jim is back to drinking water, and I am relieved no one is stopping him. I learn the woman who had been helping us is an off duty ER nurse. She comments that Jim’s color is returning back to his ears and I confirm the pink is there and feel a dose of settling relief.


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