Code Black

Two nights later, Frank was gearing up to ask the question again. I’m honestly surprised he had let it lie as long as he had. There aren’t many distractions in prison, and I was something new to break the monotony for my overly social cellmate.

About an hour after lights out, the sheets rustled as Frank turned toward me.

“Will! You still up, man?” he asked.

I contemplated not answering but knew I’d held off the conversation long enough already.

“Yeah, I’m still up. Why?” I replied.

“I was hoping we could pick up that conversation again.  The one you just had to 'put a raincheck on.'”

“What conversation?” Sarcasm has always been my favorite method of communication. I knew what he was talking about. I just didn’t want to participate.

Frank sat up and threw his excuse for a pillow at me before answering. “You know what conversation! What you in here for? Only fair ’cause I told you mine!”

Ah, yes, the reason why Frank was here. He had drunk a few too many one night and driven his car through the living room wall of a sweet, old lady’s house. She had been sitting in her favorite arm chair knitting little hats for her grandkids when he crashed into her.  Every prisoner on this wing was a killer.

“It’s a long story, Frank.”

“We’re in prison, not like I have anywhere else to be.”

Frank had settled in for a long conversation. His back was to the wall, and he was fully turned, facing me. Sighing, I sat up and copied him. Looks like Frank and I were going to have a grand, old slumber party style talk.

“Alright, but I'm keeping this pillow for the trouble."

"Yeah, right.  Give it here!"  

I threw the pillow back before starting.  "I was a first responder on the outside, a paramedic.”

For a relatively small man, Frank had a startlingly loud laugh.  “Really, man? I thought you boys were supposed to save lives, not take them.”

“Normally, we do. Or at least try to. Sometimes we get in trouble because people think we didn’t try hard enough or were negligent with care. Other times, we are still human with vices just like everyone else.”  My wife had struggled with that fact.  She acted like I was supposed to be this perfect man who could do no wrong just because I donned a special uniform three shifts a week.

Frank nodded. “I can understand that. Which kind of time landed you in here?”

“It was a little of both actually. Family was involved. My wife, Sarah.”

“Shit, your wife?! What happened?”

Frank was excited. I had never mentioned any relationships I had on the outside before.  I hadn't wanted to talk about anything having to do with myself before coming to the prison.  That part of my life was over.  It might as well have happened to someone else.  I wasn't going to be seeing the outside again for a while, if ever.  For someone as talkative as my cellmate, it was a hard concept to grasp.

“Last fall, I picked up a call late one Saturday night. It was a single-car crash. The driver had made the wrong kind of friends with a tree. When I pulled up to the scene, I recognized the car.  It was my wife’s." It had been so dark that night, I didn’t realize at first.  Normally, first responders are not allowed to treat family.  But, I'd already been out of my vehicle and geared up before I looked at the license plate.  Judging by the state of the car, there was no time to wait for other help.  

“So your wife basically ran into a tree?”  He asked skeptically.

“My wife wasn’t the one driving.”  That had been a shock, worrying my wife was dead but seeing another person in her place entirely.

Frank leaned forward off the wall, intrigued by my answer. “Then who was?”

“My best friend, Tom. My wife was in the passenger seat.”

“What was your best friend doing with your wife out late on a Saturday night?”

“Apparently, cheating on me.”

Frank was leaning so far forward at this point, I wondered if he might fall off his bunk. 

“Had you known before that night?”

“No. No, I hadn’t. I had always thought he was like a brother to me.”  Twenty years.  We had been friends for more than twenty fucking years.

“How did you know they were cheating then.”

I could hear one of the guards start walking down our hallway on his patrol with echoing footfalls we were expected to be sleeping through right now. I waited until they faded away on the opposite end before answering.

“I knew they were cheating because when I walked up to get a look at what I was dealing with inside the car, I didn’t just see Tom instead of my wife in the driver’s seat."

"What else did you see?"

"I saw my best friend’s dick stained with Sarah’s favorite shade of lipstick and Sarah herself lying topless across the middle console.”

Frank slapped his knee, chuckling.  “Well, fuck! That’s rough, man. What did you do?”

“I began doing my job is what I did. I wanted to hit something, but I would deal with all the emotions later. They were both pretty messed up and both unconscious. I used START--”

“Start?”

“No, S.T.A.R.T. Or simple triage and rapid treatment. It is a system used to gauge and prioritize which patients need care most urgently when care or personnel is limited on a scene with multiple casualties.  Almost every first responder trained in the United States uses it.”

“Ah, so who had the worst injuries?”

“Tom had a severe laceration on the left side of his neck, probably from the glass of the busted window. It was bleeding heavily but contained enough to still treat if I put him first. My wife, on the other hand, had not been wearing a seat belt. Her right side had massive bruising and multiple broken ribs that I could feel, from where she must have crashed into the dash. Her breathing was noticeably labored along with numerous lacerations.” She had been lying face down. I completed my assessment without turning her over. I wouldn’t have been able to complete my job if she’d been staring at me.  She was already unresponsive at that point.

“How did you treat them then?”

“According to START, my wife was what is considered a code black."

"Code Black?"

"START uses a color system to designate the priority of a patient based on the injuries threat to a patient's life and ability to move out of toxic situation, like a bombing or a fire.  Green means the patient can move on their own and has relatively minor injuries.  Yellow is used for patients that need assistance to move or injuries that need to be taken care of pretty soon.  Red are patients that might not be able to move or need immediate attention for life-threatening injuries.  Black is used for the dead or dying, those patients that would almost certainly die even if given immediate treatment."

"I'm sorry man, it must have been hard realizing she was not going to make it."  Frank said sincerely.

"Yes, with massive internal bleeding and restricted breathing, she was very unlikely to survive even with immediate treatment. Tom, however, was a decidedly a code red. He would almost certainly survive, but only with immediate care. If I gave him that care, I would definitely lose Sarah then.”

“Who did you choose to try to save then? Your best friend or your wife?”

I couldn't answer him right away.  I had loved the both of them in different ways, but they had both betrayed me.  “I did my duty. I worked on the one most likely to be salvageable. I saved Tom’s life as my wife’s slipped away.  It was the technically right thing to do.  Emotionally or morally for that matter?  Jury's still out.”

Frank looked at me with a puzzled look on his face. “If that’s what you were supposed to do, then why are you in here? Did they throw the book at you for doing your job?  It's not your fault your wife wasn't treatable.”

“No, I’m here because I went to Tom’s house two days after he was let out of the hospital.  I shot him five times in the chest. One for every minute that it took for my wife to die after I started treating him instead of her.”

**Written for an offsite moral dilemna contest: 'You are an emergency worker who has just been called to the scene of an accident. When you arrive you see that the car belongs to your wife. Fearing the worst you rush over, only to see she is trapped in her car with another man. He is obviously her lover, with whom she’s been having an affair.

You reel back in shock, devastated by what you have just found out. As you step back, the wreck in front of you comes into focus. You see your wife is seriously hurt and she needs attention straight away. Even if she gets immediate attention there’s a very high chance she’ll die. You look at the seat next to her and see her lover. He’s bleeding heavily from a wound to the neck and you need to stem the flow of blood immediately.

If you attend to your wife, her lover will bleed to death, and you may not be able to save her anyway. If you work on the lover, you can save his life, but your wife will definitely die.

Who should you choose to work on?'