Vitto Quintivale had been awake for 49 hours, but when something like this came through dispatch he had to get pumped up—was keyed to the max. Vitto had been an emergency room tech for three years, and advanced to orthopedics—which drove him crazy—nothing but building casts. Vitto wanted to be an E.R. surgeon, so had asked Doctor Arypasha what his course of action should be while he worked his way through medical school.

Doc Ary had recommended that he get into the ambulance; that being the man on the scene would effectively make him the triage nurse and E.R. physician until that point when he hit the E.R. and handed off the case.

And now, as his nose was in his epidemiology textbook, a call came through from dispatch and Ivan hit the siren and slapped him on the thigh. “Okay Doctor Funkenstein we’re back in the trenches bro. Go freagin’ figure, some douche bag gets all stabbed up by an old lady on Wysteria.”

With those callous words Ivan slapped his static cling ‘L’ on the interior windshield, which was his middle finger to the idiots of the world. If you did some stupid shit and ambulance 213 got the resulting call, Ivan, the African American Estonian, waxed critical until he and ‘Doctor Funkenstein’ rolled your gurney off the back end—unless of course you were a hot chick and then ‘Ivan the Hero EMT’ would be your cheerleader as Vitto actually saved your dying ass…

They rolled up onto the lawn and Ivan did a doughnut in the snowy turf, basically stripping a pallet worth of sod from the once neatly manicured yard.

“Christ Ivan, the old lady’s going to have to hire a landscaper now!”

"Just load the meat on the wagon ‘Doc’, that bitchass nigga from Anchorage just challenged Ivan—can you fucking believe that shit!”

With those words Ivan picked up his tablet and began cursing at it and thumbing the display, as if they did not have a critical case inside this blue frame house with the ancient gables.

Vitto was never at a loss for opportunities to be awestruck by Ivan’s capacity for callous disregard and his appetite for playing Gears of War for bet money through the Cayman Islands outfit which he claimed was founded by his half brother, who of course ripped off Ivan’s profitable idea…

Vitto ripped the gurney out of the back as he dragooned the two cops milling around on the porch into his own little MASH unit. He got them on both sides of the unit and charged into the house past another officer as he answered the lady cop’s complaint behind him. “My partner is consulting on an emergency over on the West Side—Newbie in over his head, follow me.”

In the mean time Ivan was launching RPG rounds at the enemy on his tablet.

The responding officer was walking him down a long dim corridor to a kitchen where a body could be seen on the floor. In a sitting room off to the left a female officer was comforting an old sobbing lady who had blood all over her hands.

The responding officer looked like a Boy Scout and was highly excited, hissing in Vitto’s ear, “D.O. goddamned A, man! This dude is fucked. I did detect a pulse, but you ought to see what that crazy old bitch did to him.”

They emerged into the kitchen to see a Jack Russell terrier licking the bubbling lung blood off of the homeless dirt bag’s perforated chest. The open windbreaker and the carnage made him look like a steamed crab with the back removed.

Look at this dude, looks like he could be my older brother. A homeless Italian—Mom would be shocked.

The dog snarled as he shoved it across the floor and got to work. There were bilateral perforations: lung, kidney, liver. The aorta and heart were not apparently hit, otherwise this really would be a done deal. The guy had third degree frost bight on the extremities and what was left of the face, and was nearly hypothermic. As the gurney rattled down the hall he checked the airway before applying oxygen. As he tilted the head back slightly and looked into a perhaps 40 year old mouth that had no front teeth intact, and was showing recent gum trauma, the tongue, which was too pale, flattened out and a gurgling gasp came up from the abdomen. Vitto expected a gout of blood and a black mark on his record for rupturing—then it came, a hollow icy breath that chilled him to the core as it blew into his face and the eyes of the man opened insanely wide, pupils dilated to the point that only a blood shot rim was visible around the huge opal center of the eye.

“No,” he croaked as he fell back against the wall with an icy chill in his throat. The damned dog began snarling at him.

The cop exclaimed, “Jesus God!” and backed away as a fountain of dark arterial blood—too dark he thought—erupted in a bubbling pool that seeped over the cracked lips and split face, and ragged blood-matted beard, below the seared and broken nose.

“Are you okay?” came the voice of a female officer, as two small hands shook his shoulders.

The room spun before him and her face seemed to elongate and streak, her pretty blond hair playing like a halo of creeping vines, her cute blue eyes graying like a winter sky.

He could feel his heart beat—could have counted them with his pounding ears—and experienced a searing pain in his kidneys that suddenly abated. He forced himself to stand, wanted to get to his patient—and then saw two of the male officers dragging the dog off of the deceased’s chest, where the fiendish little thing had leaped to begin lapping up blood from the mouth. The other cop was hurriedly tossing the sheet off the gurney over the body and shouting, “I have never seen no shit like that. We’re leaving this for the coroner. Mary, get a detective down here.”

The female cop’s hands felt welcome pressing against his chest as his heart raced. He wanted to seem strong before her—she was fine, and kind, and he was oh so lonely working and schooling full time.

“I’ll be fine officer, thank you, really.”

“Are you sure?” she said as he broke away and stepped off, but not taking his eyes off of her cute little face.

“Yes, I’m good.”

Then the world turned unto an ice cold pancake and he was a pad of frozen butter hitting it at the speed of fallen hope.