2021 Winner

I stood in the triage area of Caboolture Hospital, fingers tapping on the lid of my closed Toughbook, feet planted firm so my body formed a roadblock. Nurses and doctors wandered by, avoiding eye contact, like I was a street beggar hoping for loose change. It was the daily power play at the paramedic-hospital interface. If they could somehow ignore me, they’d delay having to deal with their next customer.

I closed my eyes, sucked in a deep breath, and eased the air out of my lungs. When people picture the stressful life of an ambo, they might envisage blood, gore, and twitching body parts. Not for me. It was this sort of bullshit that wound me up.

After a couple of minutes of yoga breathing, I opened my eyes to find a nurse in front of the triage computer. He had a flat-top haircut and a scowl that matched his demeanour.

“What’ve you brought in?”

“Someone who wants to sit in your waiting room.”

He stared at me, then sniffed as he stood a little straighter. “I will be the judge of that.”

As he hit the keys to enter his passcode, I gave a disinterested shrug. Neither my patient nor the nurse warranted a further increase in my blood pressure. After providing some details, he again asked me to explain my presence. 

“Simon here is a 22-year-old gentleman who thinks he’s suffering a haemorrhagic stroke.”

We both turned to look at Simon, who was sitting on one of the plastic chairs against the wall, inspecting the finger he’d just pulled from his nose. He met our gaze, nodded, and gave us a grin before returning to his finger.

The triage nurse’s brow furrowed. “And his symptoms are?”

“Mild nausea. I suggested it was more likely due to the squalor he was living in, or the four-day-old KFC he’d eaten for breakfast, but apparently Google reckons it could be a stroke.”

The nurse closed his eyes as his fingers hovered over the keyboard. Then his shoulders sagged, and he shook his head. “Oh, for fuck’s sake, send him to the waiting room.”

I nodded and gestured to an alcove. “Come on, Simon. This way.”

After dumping off the patient, I made my way to the write-up room where my crewmate, Scott Richards, was sitting, feet on a desk, polystyrene cup in hand. “Christ, he was a bit spesh. Gotta love Google Doc. Reckon he’ll get a CT scan, boss?”

I picked up the cup of tea sitting on the side. “Only if they feel the need to prove there’s a brain in his skull. Thanks for the brew.”

“No worries. You looked like you needed one. Perhaps some day they’ll send us to a job that requires your ICP skills.”

“Don’t get your hopes up.”

As I spoke, the radio on Scotty’s belt crackled into life. “Bravo 992, you’ve been dispatched on a 1A in Caboolture, central stab wound, details on your MDT.”

There was an instantaneous response from the targeted crew. “Comms, this 992. Do we have an Alpha attached?”

“Your closest ICP is coming from Kedron, as well as the Doctor Car.”

“Roger that.”

Scotty took a sip of his drink and looked my way. “Pretty sure the closest Intensive Care Paramedic is standing in front of me. Why don’t they ever bother looking for the Alphas on trucks?”

I sighed and threw my tea into the sink. “Now there’s the million-dollar question. Come on, let’s dance. This sounds a lot more interesting than Simon Says Stroke.”

As we marched out to our ambulance, Scotty called up on his radio. “Comms, this is

Alpha 942. I think we might be closer to that 1A in Cabo.”

There was a pause while they located our call sign on their ‘Big Picture’. “Er… Roger that 942, thanks. Dispatching you now.”

The Mobile Data Terminal and pagers all began beeping as we launched ourselves into the cab and Scotty screeched away from the ambulance bay.

I pressed the relevant buttons to silence the alerts and scrolled through the information on the MDT. “Go easy, Scotty. We’re still in the car park. Don’t forget that speed bu…”

My body jerked upwards, only the seatbelt preventing me hitting the ceiling, as our

Mercedes Sprinter shuddered from the force of a Titanic-iceberg impact.

We took off, then crashed down to earth with an equipment-rattling thud.

“Sorry, boss. Don’t usually come to this hospital.”

I stared at him. “Don’t bullshit me, Scotty. You did that on purpose.”

He gave me one of his trademark stubbly grins before focusing on the road ahead. “You know me too well. Anyway, does this job sound legit, or are we going to a shaving cut?”

I read the info again. “It’s either real or a hoax. The caller said there’s a knife sticking

out of their chest.”

“My money’s on a hoax. We’re in Cabo. Plenty of cockheads who like poking the emergency ant’s nest.”

I gave a shrug. “Also plenty of residents tooled up with knives.”

“True.”

We hurtled along King Street, flying through the lights in front of the police station, then shot off into a suburban sprawl. The sight of the cop shop caused me to pick up the mic.

“Comms, this is 942. Are we staging for police?”

“Negative 942, QPS are already on scene. It’s safe for you to approach.”

“Roger.”

Scotty flipped off the siren as we made the last satnav-dictated turn into a nondescript street. About fifty metres away, a man in his late twenties lay on the ground, propped up against a garden wall. The midday sun cast dark shadows that dulled the light reflecting off the pool of blood congealing on the tarmac. Two police officers were kneeling beside him, while a group of onlookers gawked at the morbid spectacle.

I took my sunnies off and slotted them in my pocket. “Looks pretty legit to me.”

“If it ain’t, it’s an elaborate hoax.” Scotty pulled up nearby. “Hey, we’re here first. I thought we were backing someone up?”

“Guess you drove too fast. Again.”

We slipped on our gloves as we alighted from the ambulance, and I approached the scene while Scotty retrieved our kit. “Hi guys, I’m Jon, what’s the story?”

A male and female cop were applying pressure to both his arms, their black latex gloves gripping the blood-soaked towels wrapped around his limbs. They looked up at me as if there was a halo round my head.

“Oh thank Christ you’re here. This is Seth, he’s got multiple cuts to his upper body, but

the ones on his forearms are down to the bone.”

Although blood covered his shirt, and dried rivulets decorated his scruffy jeans, there was no obvious chest injury. I bent down and felt a strong radial pulse. “So where’s the knife? Did you pull it out?”

The male cop frowned. “Knife? There wasn’t one. He’s ran here after being attacked elsewhere.”

Scotty dumped the monitor next to me and I began applying the BP cuff. “We had a report the patient had a knife in their chest.”

Our patient felt it necessary to interrupt. “It was that fuckin’ mad bitch. I woke up as she came at me, swinging a fuckin’ carvin’ knife. Can you fuckers do something, I feel like shit!”

Seth had a high tatt-to-tooth ratio and clinical signs of hypovolaemia; he’d lost too much blood. He was pale, sweat peppered his forehead, and the probe Scotty placed on his finger revealed a fast heart rate.

“Give us a moment to check you over, mate, then we’ll make you feel better. Was anyone else injured?”

His eyes darted back and forth between the cops. “No, just me.”

Sirens swirled in the background as we prepared to expose his right arm. Taking care, I peeled away the towel. Clots of gelatinous blood stretched like pizza topping, but as a deep laceration came into sight, a spurt of blood shot out flying past Scotty.

“Wow! Watch it, boss.”

“Gotta get you back for that speed bump. I’ll apply pressure, if you can sort out a tourniquet.”

“On it.”

“OK, Seth, one of your arteries has been cut in your right arm, so we need to stop the blood loss with a tourniquet. I’m not going to lie, it’ll hurt, but it’s better than the alternative.

We’ll give you some pain relief as soon as we can, OK?”

“Whatever.”

A few moments later Scotty was cranking the pressure on Seth’s upper arm and the next time I removed the towel the wound had stopped bleeding. As I was applying a trauma dressing, the primary crew arrived. “Hey, Jono. What d’you need?”

I looked up to see two colleagues I recognised, but for the life of me couldn’t remember their names. “G’day, this is Seth, he’s been the subject of a knife attack. Can you check if he needs another tourniquet on his left arm, while I try to gain access.”

Scotty reached for the kit bag. “I’ll get some pain relief sorted. I presume you want fentanyl, boss.”

“Yes please.”

We all busied ourselves with our tasks as a marked-up sedan arrived, and Dave Benson, the Deputy Operations Manager, levered himself out of the driver’s seat. I glanced up and cringed. He was the dick who put ‘urea’ in bureaucrat. It was probably why I liked taking the piss out of him. I mumbled a warning to the others. “Watch out, Benno’s about.”

There was a collective groan, but no one looked up. Benno grabbed his belt and hoisted his trousers under his belly before strutting over towards us. “What’s the story, Byrne?”

“G’day, Benno. Multiple knife wounds. Arterial bleed on the right arm…” I looked back at the paramedics treating the left and received a shake of the head with a thumbs up, “… but only a deep lac to the left. No central stab wounds and no knife in situ, so I’m not sure where that story came from. As far as the cops are aware, this is the only patient.”

As I spoke, Benno had answered his phone and was paying more attention to the device.

“Uh-huh, right. Where? OK… yes… yes… yes… yes… Right, will do.”

He hung up, and I grinned. “Who said you weren’t a ‘yes’ man.”

He glared at me. “Don’t start, Byrne. That was Comms. There was a second call for a stabbing they appended to this case, but they’ve just realised it was from a different address.

It’s down that street over there. I’d better go check it out.”

I shrugged. “Sure. I’m guessing it’ll be where he was attacked, but best take the cops with you. We’re fine here.”

He nodded and strode off, the police officers looking relieved to be leaving our bloodsoaked patient.

“Right, Scotty, what’s the story with Seth?”

“Pretty good, boss. Obs normal other than a heart rate of 112. The left arm only needed a pressure dressing and the right’s controlled with the tourniquet. We’re all waiting on that access you promised.”

“OK, OK, I’ve got the stuff ready, just gotta find a vein. Guess I’ll have to use his feet.” I removed one of Seth’s trainers and pulled a grubby sock off, only to regret my decision a moment later. In an instant, the mildly disconcerting smell of fresh blood had been usurped by a gut-wrenching stench that hit my nasal cavity like a Tyson-knockout blow. My eyes watered as I reeled back and turned to my crewmate with a contorted expression. “Can you please get me an alcowipe? Y’know, one of the big ones.”

Scotty frowned, but then nodded with a grimace as the fetid odour entered his nostrils. The other two paramedics began coughing. Only Seth seemed unperturbed. My crewmate backed away and soon returned from the truck with a medical waste bag and a green pack of hospital-grade sanitising wipes we use to disinfect the ambulance. “These should do the trick.”

As Scotty sealed the offending trainer and sock in the yellow plastic sack, I cleaned

Seth’s foot with the wipes. “Seth, I have to say you have some impressive bromidrosis.”

“Wha’?”

“You should wash your feet more, my friend.”

“Oh, yer. It’s me trainers. They make my feet stink.”

“Mmm… yes, well, I’m going to put a needle in your foot as both your arms are injured.

Sharp scratch.”

With the cannula in place, I gave him some pain relief, and then it was time to leave.

“OK, if you guys help get him on our stretcher, we’ll take him in.”

As Scotty walked to our ambulance, there was a yell from down the road and Benno came running into sight. His voice was somewhere between a shout, a scream, and plead.

“Jono! Jono! You’re needed up there!”

All four paramedics stared at the DOM as he hurtled towards us, waving his arms and pointing behind him. I’d never seen him move so fast. He reached us in a sweaty lather of trembling teal uniform and bent over double, holding his knees as he sucked in his breath.

“What’s going on, Benno? They didn’t ask you to treat a patient, did they?”

“Fuck off… The patient… with the knife… in her chest. She’s up there!”

“Right.” I turned to the other crew. “Can you guys deal with Seth? You might want to leave before the Doctor Car arrives. Best not distract them. How far is it, Benno?”

“Just round… the corner. I’ll get another… crew dispatched… to help… with extrication. Go! Go!”

I nodded to Scotty, and we both grabbed our kit bags and started striding off in the direction he’d indicated. As we reached the corner, Scotty grinned. “Isn’t Rule Number One:

paramedics never run?”

I nodded. “It still is. He’s not a paramedic. He’s a manager.”

“Good point.”

Although it may seem counterintuitive, laziness is not the reason we avoid running. It suggests a lack of control and if the folk arriving to sort things out don’t look calm, panic spreads faster than Seth’s foot stench. However, as beads of sweat broke out across my forehead, I regretted the decision to leave our ambulance behind. It was like my umbilical cord was being stretched to breaking point.

I wasn’t the only one suffering. Scotty’s close-cropped haircut had begun to glisten. “How far is this address, boss? And why didn’t Benno just radio it through? He must have left those two poor coppers to deal.”

I shrugged as I adjusted the heavy kit bags on my shoulder. “I wasn’t joking about him not wanting to treat patients. He always avoids it, but I reckon it’s better for them. Anyway, I guess we keep following the blood trail.”

The dark-red splashes, now dry from the sun, eventually turned into the concrete path of a weatherboard lowset house, then disappeared off across the dirt around the side of the building. The front door was hanging off its hinges, the shattered door jamb littering the entrance with shards of creamy exposed wood as the fly screen creaked a welcome.

On stepping inside, I noticed a size-twelve boot print scuffed in the door’s tired paintwork. “Hello, ambulance.”

“In here, quick!”

We made our way along a dingy corridor, strewn with human artefacts, detritus of an unkempt life. Framed pictures of yesteryear lined the hallway, discoloured with age, their memories clouded by the passage of time and years of accumulated dust. One had been knocked from its perch, leaving a silhouette on the wall marred by a streak of blood.

We stepped into a brighter living area and were greeted by the sight of a woman in her early twenties covered in blood, a kitchen knife protruding from the right side of her chest. She was writhing on her back, being held down by the two cops, her long blonde matted hair mopping up the blood on the floor. She looked like a skewered version of ‘Carrie’.

The male police officer glanced up as we walked in. “We need some help here!”

I looked around for somewhere to place our kit that would reduce subsequent cleaning.

“No worries, mate. What’s your name, darl?”

She stared at me, eyes wide with the knowledge her life was circling the drain. “Laycee. He came at me with the knife. I got it off him at one point, hit him back… but he was too strong. I told him I was leaving.”

She gestured with her hand to a suitcase in the corner, on its side, spewing clothes.

“Don’t worry about that now, let’s get you sorted.” She had a weak thready pulse in her left wrist and the knife didn’t look too deep. Her right arm had a long gaping laceration that was being controlled by a leather belt wrapped around her bicep. I grabbed my stethoscope from its pouch and listened to her chest while Scotty started attaching the monitoring. She had good lung sounds and there was no evidence of air tracking under her skin. The lack of surgical emphysema meant a punctured lung was less likely.

I grinned at the cops. “Out of the frying pan into the fire, eh? Good work with that belt.”

The female officer smiled. “I saw what you did with the other guy and improvised.”

“Brilliant, just what she needed.” I looked at the monitor and was surprised to see all her vitals within normal limits. Breaking out a mask from the oxygen kit, I turned to my colleague. “Right, Scotty, I’ll put her on oh-two if you can get a line in. I’ll find out what the story is with the backup crew.”

He nodded and threw me his handheld as I stood up. “Here, have this. I’m guessing you haven’t got yours.”

I grinned. “You know me too well.”

While depressing the transmit button, I surveyed the scene. The back door was closed, but blood splatters were smeared around the handle, like someone had been trying to get out. A sofa was upended; a table sat at a jaunty angle; and a matching heavy wooden chair lay outside on the dirt. It looked like it had been thrown through the shattered louvre window.

“Comms, this is 942. How far away is that backup crew?”

“Er… 953 should be arriving now.”

“Roger. Can you get them to bring in their stretcher and scoop?”

“Comms to 953. Did you copy last?”

“Roger that, will do.”

“Comms to 942. The Doctor Car is about ten minutes out. Do you still need them?”

“Yes. We’ve found the patient with the central stab wound. Might’ve helped if I knew we were looking for a woman.”

There was a long pause before Comms acknowledged my transmission. “Roger.”

I bent down and clipped the radio back on Scotty’s belt as he was securing a cannula in our patient’s uninjured left arm. He turned to look up. “Did you have to have a go at

Comms?”

I shrugged. “No, but any chance I get to stick the kni–ooow let’s work out how we’re going to extricate Laycee.”

Scotty closed his eyes and grimaced as I mirrored his expression, hoping we were the only ones who noticed my faux pas. A shout from the front door saved my embarrassment.

“Are we good to come in, Jono?”

I recognised the voice straight away. “Sure, Addy. But you’ll have to engage your language filter. We’ve got cops here.”

There were clattering noises as they negotiated the cluttered hallway before a stocky short-haired woman entered, pulling a stretcher followed by a young recruit. Addy turned and placed her hands on her hips as she took in the scene. “Fuck me.”

At least she’d limited her usual expletive-laden assessments to just one. “Right, this is Laycee. The plan is to scoop her onto the stretcher. We’ll deal with securing the knife in position when she’s there. It would be great if we can get her loaded before the HMO arrives. While we prep the scoop, Addy, could your offsider draw up some fentanyl and Scotty, can you replace that belt with a tourniquet?”

“Sure, boss.”

Addy grabbed the scoop off the top of the stretcher and laid it on the floor next to our patient. “Jesus, Scotty, don’t call him that. His fuckin’ head’s big enough as it is.”

“Love you too, Addy. OK, we need at least three of us on this side to do a log roll.” I snatched a folded sheet off their stretcher and unfurled it alongside Laycee, giving us all something to kneel on without getting covered in blood.

The cops took up positions to help with the move as Scotty finished applying the tourniquet. “See, Addy, that’s why he’s the boss. You’d have got blood on your knees and skived off for two hours to do a uniform change.”

“Yer, great. Thanks, ‘boss’.”

We rolled Laycee just enough to allow Scotty to slide the scoop under her, but even that shallow angle caused the heavy handle of the knife to topple over.

I managed a ‘whoa’, but it was too late, and the blade clattered to the tiled floor between us. I looked at the wound; there was no gush of blood and no apparent change in Laycee’s condition, but that didn’t rule out an internal haemorrhage. “Right, let’s get a move on, and mind that knife.”

Once she was on the scoop, the others lifted her onto the stretcher as I picked up the weapon by the hilt, using two gloved fingers to avoid smudging any prints.

“I’ve made the knife safe, it’s on the table. OK, Laycee, how are you doing?”

She managed a faint smile through the mask as the scoop was removed from beneath her. “I’ve had better days. My arm hurts like hell.”

I turned to Addy’s crewmate. “Sorry, what’s your name?”

“Luke. Here’s the fentanyl, one hundred micrograms in ten mils. I’ve taped the vial on the syringe for a cross-check.”

“Thanks. Allergic to anything, Laycee?”

“No, I don’t think so.”

I gave her a decent dose of pain relief as we wheeled her out of the house into the fresh air. It was nice to get away from the cloying smell of blood. As we loaded Laycee into Addy’s ambulance, a marked-up dark-blue Subaru Impreza pulled up opposite us and out stepped another ICP, Liam Fraser, along with Dr Sarah O’Driscoll, our Head Medical Officer. She was not one for small talk. Looking at the patient, she then glared at me. “What happened to the knife?”

“Hi, Sarah. It fell out during extrication. It wasn’t in deep.”

If looks could kill, the HMO would be a mass murderer. She made her way into the ambulance without another word and I followed, dreading the backlash that would no doubt come later. Liam joined us and I gave a brief handover as they began their assessment.

I dissolved into the background and made a stealthy retreat, while they discussed FAST scans, blood warmers, and infusions. Once outside, I helped Addy with her gear.

She was not in a good mood, but kept her voice low. “Shit, Jono, I’m sick of going to fucking domestic violence cases. Whoever did this to that sweet young girl should be strung up, after they’ve had their fucking balls cut off.”

“Well, thanks, Addy. All I can say it’s lucky you didn’t back us up to the first patient.”

“Too fucking right! I hope you didn’t give him any pain relief.”

“C’mon, Addy. You know the rules, patch up without prejudice. We’re not judge, jury, or executioner. Both our patients got the same level of care. Now get in your bus and drive the doc squad to the Royal. If you get the keys off them, Luke can drive their car up. I think the less interaction I have with the Big ‘O’ the better.”

She grinned and nodded. “Ain’t that usually the case?”

I smiled back. “Yep. Can’t imagine why I piss her off so much.”

“It’s a knack you have. And don’t just single her out. You piss off all the management.

Catch ya later, mate.”

I joined Scotty to help collect up our equipment outside, and we watched as the lights began whirling before the ambulance left for the hospital. We looked at one another and I gave a shrug. “Cool. Two real patients and no paperwork. Can’t get better than that.” Scotty sniffed. “Bit of a pity, though.”

“Why?”

“I wanted you to write in the notes: the patient described her pain as ‘stabbing’.”

“True. It’s a missed opportunity.”

“Joking aside, boss. What was he hoping? That no one would check his address?”

I sighed and shook my head. “Can’t believe the bastard said no one else was injured. If

Benno hadn’t gone and checked, it could’ve been a whole different story.”

Scotty raised his eyebrows. “Did you just say something positive about Benno?”

“Sure, why not. That mental image of him flapping towards us like a demented emu will give me a warm glow for months.”

He nodded. “That was hilarious.”

While we’d been chatting, a steady flow of police vehicles arrived on scene. 

“Hey, Scotty, are you able to get our ambulance? I’ll hold the fort here, but it might be nice if we can make a quick getaway.”

“Will do, so long as you only give the cops your name. I could do without a court summons.”

“Deal.”

He left before a man in blue jeans and an ill-fitting shirt approached me. He was in his late forties and had a tanned face with dark, slicked-back hair. “Excuse me, I’m Detective

Giallo. Do you have time for a few questions?”

I gave a shrug. “Sure. Jonothan Byrne.”

We shook hands, and he retrieved a crumpled pack of cigarettes from his pocket, offering them with a gesture. I declined and he tapped one out. “Mind if I do?”

I smiled. “Go for it, so long as years from now you don’t mind me saying ‘I told you so’ when you call me gasping for breath.”

He nodded. “I’ll take the risk.”

He lit up and took a deep drag. “So, which person did you attend?”

“Both of them. There was some confusion because the initial report was for only one patient.”

“And you found the man first?”

“Yes.”

He pulled out his phone and showed me a mugshot of Laycee. “Is this the woman you treated?”

“Yes.”

“Tell me, were her injuries to her right or left side?”

“Right arm and the right side of her chest. Why?”

He drew again on his cigarette. “She’s left-handed. How significant were her injuries?”

“I think most of her blood loss was from the arm wound. The chest injury was… well, let’s say the knife fell out when we moved her. It sure made managing her a lot easier.”

He paused for another drag. “Did you see any other knives lying around in there?” He nodded towards the house.

I cast my mind back to the chaotic scene. “No. Just the one in her chest. I placed it on the table. Did you want me to show you?”

He smiled and shook his head. “No. You guys only get one free pass to trample my crime scene, then it’s revoked. Anything else you noticed?”

My Spidey senses had picked up on his line of questioning, and I had some idea where he was going. “Yes. Both the doors were deadlocked. The front had to be kicked in, and there were blood smears on the back door. Seth, the man we treated first, couldn’t have locked the front when he left. He had an arterial wound and there was no blood on the doorstep. He must have escaped by throwing a chair through the window, which is strange if he was the assailant.”

Giallo smiled as he tapped away some ash. “I could make a detective out of you yet.”

“I can’t be that good. It was only your questions that got me thinking. So, what made you suspicious?”

He blew smoke out his nostrils and smiled again. “You know how a jury’s not allowed to know about the accused’s previous convictions because it could influence their decision? Well, any investigation relies on that sort of intel. She’s got a history of similar attacks.” He took a last drag before flicking the stub into the road. “I reckon the Queensland law against keeping rabbits is the only thing stopping her from boiling someone’s bunny. I’ll be in touch.”

He gave me a wink and strolled off as I stood on the kerb, feeling shell-shocked. Scotty pulled up beside me, and we loaded our gear before driving away. “You’re quiet, boss.

What’s up?”

I let out a sigh, as if it would release all my mixed emotions, but the weight of the knowledge was still heavy. “It was her.”

“What?”

“Laycee. She cut her own arm and stabbed herself in the chest to frame Seth.”

“You’re shitting me?”

“Nope.”

“How d’you know?”

“The detective said she’s done it before. It’s why Seth said no one else was injured.

When he left, no one else was. He was telling the truth.”

Scotty joined me in the thousand-yard stare. “Shit.”

Our joint soul-searching of the human condition was interrupted by the radio. “Comms to 942, the DOM has informed us you’re clear of the last case. He’s asked to dispatch you on a pending 2C. An 84-year-old man is suffering explosive diarrhoea, details on your box.” The MDT started beeping as both Scotty and I yelled in unison. “Benno!”