Zero Day (John Puller, #1)(36)

“How about aspirin?”

“Same place.”

“Tell me where.”

“Bedroom nightstand.” She pointed with a shaky finger to her left.

Puller was back in ten seconds with the bottles of pills in hand.

He gave her aspirin with some water. If she had a clot, aspirin was a good way to prevent platelet clumping. And it kicked in fast. And it didn’t screw with your blood pressure.

The problem with nitro was that it only treated symptoms, not the underlying coronary disease. It would help with her chest pain, but if her blood pressure was already low the nitro would push it lower still; that’s just the way it worked. That could significantly worsen the heart problem and also cause organ shutdown. He couldn’t risk that. He had to know first.

“You have a blood pressure cuff here?”

She nodded, pointed to a shelf behind the counter.

It was one of those battery-operated devices with a digital readout. He grabbed it, slipped it on her right upper arm, hit the on switch, and watched the cuff inflate. He read the results.

Not good. Pretty low already. Nitro might kill her.

He looked her over. No sign of retaining fluids, swollen feet, or vascular problems. “You on any diuretics?”

She shook her head.

“I’ll be back in ten seconds,” he said.

He raced to his Malibu, popped the trunk, grabbed his first aid bag, and ran back, his long legs chewing up the distance.

When he got back she looked worse. If the heart crashed now, the EMTs, instead of saving her, would pronounce her dead when they arrived.

He opened the kit, readied his equipment. He talked to her the whole time, trying to keep the old woman calm. One ear listened for the ambulance.

He had done triage in the middle of nowhere with guys who looked like red chunks of meat. He had saved some, lost others. He had made up his mind he was not going to lose her.

Puller swabbed her arm with alcohol, found a good vein, and inserted the needle, taping it securely to the inside of her forearm with white medical adhesive. He screwed the other end of the line into the IV bag of saline he’d pulled from his kit. Fluids got the blood pressure up. Same method the docs used to save Reagan after he’d been shot. It was a liter bag with an eighteen-gauge line. It was a gravity feed. He held it above her head and opened the feed wide. It would take twenty minutes to empty the bag. She had five liters of blood total. A liter of saline would boost her by twenty percent.

When the bag was half empty he punched the on button on the cuff again. He read the numbers. Both were up to safer levels. Whether safe enough he didn’t know, but he didn’t have much choice. She was gripping her chest tighter. Her moans both deepened and lengthened.

He said, “Open your mouth.” She did and he slipped the nitro tablet under her tongue.

The nitro pop worked. A minute later she was calming; her chest stopped heaving. She took her hand away from it. With heart distress, your artery was undergoing spasms. The nitro knocked that out. With the spasms gone lots of good things could happen, at least until the ambulance arrived.

“Take long, deep breaths. Paramedics are on the way. Aspirin, nitro, and fluids have helped. You’re looking better. You’re going to be fine. Not your time yet.”

He hit the cuff button again. Read the numbers. Both up. Both better. Her color was improving. It was a mini-miracle in the middle of coal country.

“Hospital is a long way away,” she gasped. “Should’ve moved closer.”

He grinned. “We all have regrets.”

She smiled weakly, took his hand. He let her squeeze it as hard as she wanted. Her fingers were tiny, weak. He barely felt the pressure, like a rippling breeze. He could see her face relax. Her teeth were yellowed, black in places, gaps in other places, and nearly all the remaining teeth were crooked. And yet it was a nice smile. He appreciated seeing it.

“You’re a good egg,” she said.

“Anything you need taken care of around here? Anybody I should call for you?”

She shook her head slowly. “Nobody but me left.”

Up close Puller noted the heavy cataracts. It was a wonder she could even see him. “Okay. Deep, steady breaths. I hear the siren. They know it’s cardiac. They’re coming prepared.”

“I thank you, young man.”

“What’s your name? Annie, like on the sign?”

She touched his cheek, thanked him again with a shaky smile, her lips curling in pain with each beat of her creaky heart.

“My name is Louisa. I can’t really tell you who Annie was. Name was there when I bought the place and I didn’t have the money to change it.”

“You like flowers, Louisa? I’ll send you some in the hospital.” He held her gaze, willing her to keep calm, breathe naturally, and not think about her heart trying to stop forever.

“A girl always likes getting flowers,” she replied, her voice weak.

He heard the engine, followed by the crunch of gravel, doors opening and closing, feet running. The paramedics were swift, efficient, and well trained. He told them about the aspirin, nitro, the fluids, and her blood pressure. He listed her symptoms, because she didn’t have the strength to talk now. They asked all the right questions, spoke calmly, and had her masked on oxygen and on a fresh drip within a few minutes. Her color improved even more.

One EMT said to him, “You a doc? Did all the right things.”