PRN Hospital: From Birth to Death

Snowheart returned from her memory. It had taken milliseconds to recall the whole ordeal. Klinger had teased him for nearly using his mouth. The nurse wondered how bad the medic hazed him this time.

“No, it wasn’t the Spitfire thing,” Ace sighed. “A call came in during the day. It was… much much worse.”

“Please illuminate me,” requested Snowheart. She shimmied closer. The studies had shown that stallions preferred close contact within courtship situations. Perhaps the ensuing endorphin release would remove his fear and sadness. Or so Snowheart hoped.

“Ok, but it’s a little messy…

Ace began to relate the story and Snowheart’s mind filled in the details.

Ace was sitting in his normal comfortable chair. It was the day shift, and that meant that the chair was outside. Klinger was flying around, excitedly talking about his date with the nurse Ivy Push.

“So then we went to a club,” Klinger called down. “Man, that filly can dance. She can kick back a few too. How did your date go, Ace? I heard you and Nurse Snowheart really hit it off. I didn’t think a pony like her would be interested in dating at all.”

“Well,” began Ace, his cheeks a bright fire truck red, “a lot of ponies misjudge her. She only seems cold. But underneath all the facts and figures she memorized is a pony that truly cares. She learned all that stuff to help others in the best way that she could.”

“D’awww, you little romantic. I bet you didn’t try anything on her yet.”

“Of course not. She’s too cultured for that. And I wouldn’t press a mare to do anything she wouldn’t want to,” Ace declared solemnly.

“Ha ha ha. Mr Noble. Well, fair Ace, while you were being all chivalrous, I was getting some.”

A snort brought both their attention to a large earth pony female. Siren laid on her back, staring at the sky.

“So little miss tease finally gave it up, huh?” she said with a piece of wheat sticking out of her teeth. “I was trying real hard too.”

“You try hard for everyone,” reminded Klinger. “You’ve made a pass at anything that moves.”

“I can’t help it,” whined Siren, “ponies are so cute!”

“But you are a pony yourself,” said Aloe as she walked around the corner of the wagon bay.

“Yeah, I guess I’m cute too,” Siren giggled. “Oh, but Kirins are very cute.”

“You have mentioned,” sighed Aloe.”Repeatedly.”

“Hello Aloe,” Klinger called down as he landed on a cloud. “Care to join the conversation?”

“Most mares do no like such talk. I am sure Ivy would not like your constant boasting.”

“That’s why I’m staying quiet,” stated Ace. He tried to return to the book he was reading on medical terminology. If his girlfriend spoke the way she did he would have to do some research to understand her.

Before he could more than glance at the page, tones rang through the air. A call. The speaker squawked to life.

“Ponyville Ambulance and Fire, respond to 26 Alder Court for a self inflicted cannon wound to the head, repeating Ponyville Ambulance and Fire, respond to 26 Alder Court for a self inflicted cannon wound to the head. Twelve thirty two.”

“A cannon wound to the head?” Klinger echoed in disbelief. “How do you do that?”

“The broadcast said self inflicted,” Aloe explained flatly. “I would assume it was a suicide attempt.”

Ace didn’t hear the rest of the conversation. A suicide attempt. He couldn’t fathom why a pony would take their own life. But they need his help as quickly as possible. He hitched his wagon and began to barrel down the road.

“Siren,” commanded Aloe, as she passed by, “get a hold of the flight crew from Canterlot. Have them launch.”

“Yeah, uh, ok,” Siren answered.

Ace noticed Klinger’s shadow pass over him as the medic flew off to the scene. Aloe’s form galloped in the air next to him. Kirin’s magic seemed to be elemental based. Aloe had explained it once but the very principle went over his head.

“I am coming to assist,” the galloping medic yelled through her created breeze. “Please expedite.”

The Kirin floated by, running on unseen puffs of air. She wasn’t as fast as Klinger, but she would make it there before the wagon.

Ace tried not to think about what this would be like. Cannons came in all forms, sizes, and types. He hoped this was merely a party cannon. The worst the pony would suffer is a blackened face and smoke in the airway. A party cannon would make a poor suicidal attempt.

Ace doubled his speed. It must be bad if Klinger didn’t make a snide comment about the flight team. His partner hated the flight medic. Dee Fibs was a ball of energy that teleported around and generally got in everypony’s way. She talked incessantly and most of what she said made no sense. Gurney Gales, the huge grey pegasus that pulled the flying carriage, must be a saint to deal with that little blue unicorn.

Ace’s consciousness slowed its rambling as he approached the scene. The door was wide open ,and bystanders or family members huddled around each other propping themselves up in their grief. Ace unhooked and walked carefully through them. He didn’t like the raw emotion. It was awful to look at ponies’ faces contorted in pain that he couldn’t help.

The scene was qu…eerily devoid of sound. Ace walked through the door and found some fire department ponies standing around. They looked at him and stepped back allowing him to pass.

Ace turned the corner and saw a sight that remained with him for a long time. The patient lay on the floor. He thrashed his pale body as Aloe tried to start an IV line. The pony’s hooves moved away from her at every attempt.

The floor was filthy. Blood and something crunchy spread all the way to the door. Ace walked closer as he tried to figure out what he could do. Klinger was by the head.

As Ace approached, Aloe’s body moved and allowed him to view the true trauma. The pony’s head was smashed. His face was opened wide with blood filling the numerous nooks and crannies that were made by the muscle tissue. A large lump of skin lay next to the gaping hole that used to be his face. Ace could see the destruction had begun with the lower jaw and pulled away from the head towards the top of the skull. The brain would still be functioning, he thought.

On closer inspection, the pile of skin he saw contained the outline of snout and eye holes. It was a deflated face staring back at him. The EMT put the thought from his mind and tried to figure out the best way to carry the patient out without the pile of face separating completely. He thought it might be best to wrap it in a pillowcase and cut a hole for the breathing tube to stick out.

Ace looked to Klinger for guidance. He saw yet another sight that would continue to haunt him. Klinger looked pale and terrified. The mouthy medic was silent. He trotted back and forth looking at the meat pile that pooled with blood.

“I don’t know which bubbling hole is his throat,” the medic finally admitted. “I can’t place a tube if I can’t find his throat. Uhh, Ace, could you get me a7.0 size tube?”

Ace lept into action. He found the medic bag, crunching through the debris. The duffle of endotracheal tubes was right on the top. The medic could slide one in and pass air directly into the lungs, hopefully. Ace worried that, even breathing, this pony wasn’t looking good. He had no idea how much surgery it would take to repair the head and wondered how the pony had survived at all. He handed the tube over to the frantic medic.

“Yeah,” Klinger said more to himself. “I could just… maybe it’s right… Dee Fibs is on the way, right? She’ll know what to do.”

Klinger was waiting for Dee? Dee Fibrillation. The medic that Klinger said was as smart as a box of wool. The medic that he said was more hassle than helpful. The medic Klinger had repeatedly dismissed on calls when she gave her opinion. This medic would know what to do?! Her!

Ace realized in that moment that the medic was panicking. The pegasus had always been an example of strength and calm. He had joked on calls that Ace had been terrified at. He said what he wanted with no care who heard. That mentor of Ace’s was now panicking in front of him.

Ace was about to say words of comfort, when the air near the doorway exploded. Well, not so much exploded as popped. A bright blue unicorn with yellow pigtails appeared.

“Alright everypony what do we have…” the enthusiastic flight medic began, but stopped as she beheld the gore. The air popped and popped again next to Klinger at the head. “Sweet Pickles! What happened here?!”

“A suicide with a cannon, Dee,” Klinger informed her.

The tiny medic glanced at the tube in Klinger’s hoof. “You can’t put a tube in that, it’s all fhfhfnf.” The unicorn explained sticking out her tongue. “There’s no lower jaw. Does he still have a pulse?”

“It’s faint, but it’s there,” Aloe informed with her hoof on the pony’s thigh. Ace noted the pony had stopped thrashing and the pool of blood around the head continued to increase.

A thought occurred to the frantic EMT. If he had no lower jaw it means the cannon had blasted it to bits. He looked down and realized the crunching things he had walked through were pieces of bone from the patient’s face. A cold feeling filled his stomach. He found himself unnerved, but not horrified. He wondered if this was a bad sign.

“Alright,” the perky little flight medic exclaimed. “If we can’t pass a tube through the trauma, we can go underneath it.”

“You mean tracheotomy?” Klinger said his mouth open wide. “It will get under all this trauma, but I’ve never done one in the field.”

“Oh,” squeaked Dee. “Now is time to learn.”

There was a pop in the air and a pop as the flight medic left and returned with her bag. She began to sift through its various contents while muttering about how messy her bag had become. Then her eyes alighted on a white piece of plastic with a sharp metal edge on the bottom.

“Ok, one trached pony coming up,” she said as she used her magic to float the device in place. “Now look for your landmarks. The bumpy spot is thyroid cartilage and ring underneath,” she indicated with her hoof, “is the cricoid cartilage. The ring goes in between. Ok, the soft spot.”

The magic of Dee’s horn increased in brilliance as the ring sunk into the pony’s neck. The metal bracket slid out in a field of lime green.

“There, now bag through that!”

Klinger attached the bag valve mask to the patient’s trach and pushed air in. Ace looked for the chest to rise but it didn’t. Instead large bubbles appeared under the skin on the pony’s neck.

“Oh horseapples! It didn’t go through right,” Dee swore. She looked for the cutting ring quickly in her bag.

“It is no use,” sighed Aloe. “There is no pulse. We have no airway. It looks like he has bled out.”

“S-s-sorry,” Dee stammered as she looked at the corpse. “I failed. Stupid ring didn’t do it’s job.”

“It’s ok, Dee,” Klinger said as he looked the unicorn in the face. “There wasn’t much chance anyway. He would have bled out anyhow. But thanks for your help.”

“You’re welcome,” Dee returned. “Call me anytime you need anything. I’ll tell the family we did all we could.”

Dee Fibs disappeared in flash with a pop. The rest of the crew slowly began to put their instruments back. Klinger looked pretty shaken. Aloe was unreadable. Ace just had that odd coldness in his stomach. They left in silence. They were at the exit when the wailing of the family began. Ace had only been working a few months but had heard his fair share of wailing. It never seemed to get any easier. The EMT wondered if he truly wanted it to. He looked at Klinger who was still pale and looked like a foal that had been scolded. He placed a comforting hoof on the medic’s shoulder as they left.

Snowheart listened with keen interest. She felt her mind swarm with a million different questions about the scene and patient. She knew those questions were not something to ask yet—if Ace would even know the answer.

Ace seemed to shrink on her. As if the story escaping him had physical mass, and its departure left him emptier. Snow just turned and held him. She waited until she was sure the story was over. No tears fell from him but his demeanor indicated a morose state.

Something within Snowheart’s calculated countenance shifted. She looked at the sad pony in her forehooves and felt a warmth within her she had no experience with, but had studied through her sisters.

“I believe I am experiencing love,” she said mostly to herself, but Ace’s head rose to look at her. “I must assist with your problem,” she quickly inserted, looking away from that inquiring face. “Firstly, the feeling of cold within you is a natural response to the release of adrenaline. Your body is attempting to aid you from danger. You saw something that is not typical to your life and your body reacts as if it is in danger. Tonight, you might experience feelings of tension or crushing chest pain in response to the stress finally reaching you. But ….”

The well informed nurse trailed off. She could see the glazed look in Ace’s eyes. This was not the information he needed at this moment. She would need the softer approach.

She remembered one of her own bad experiences. A young three month old foal was rushed to her hospital. It had been subjected to intense heat and increased carbon monoxide. Its home had caught fire. The little’s father had desperately pulled his other children from the home, but could not get close to this one in time. The little foal lied still and unmoving as the emergency wagon rushed in.

Snowheart quickly tried to ventilate the child, but it was no good. Her nursing experience and instincts informed her it had already fled for the gates of light. Still, her need to try overtook her sense. She ventilated the tiny patient for much longer than was needed. Finally, a hoof touched her shoulder. Redheart looked at her older sister with knowing eyes.

“The foal is gone, Snow,” the younger sister said.

“But we have not tried alternative treatments or any medicine interventions!” shouted Snowheart.

“Snow, she’s gone.”

“I am aware. I just felt as though… I had to try.”

“That’s all we can do. We try,” Redheart wrapped a foreleg around the distraught nurse. “We stand in front of the golden gates and try to keep ponies from entering before their time. But there is always a time. We don’t do this job to feel good. We don’t do it for praise or bits. We do it because it’s calling. Because most ponies can’t do what we do and stay sane. You see how quick the turn over rate is here. There is a reason. We are strong enough to do it. We can be kind hearted enough to connect with others, but cold enough to survive.”

Snowheart repeated these same words to the pony in front of her verbatim. She hoped that they would provide the same comfort to Ace as they had to her. Ace just stared at her. For once her fact filled mind had trouble deducing his thoughts. She cleared her throat and tried again.

“If you are floundering perhaps you should inspect your flank. The cutie mark upon there reminds you that this is your calling. You are strong enough to handle the life of medicine,” she clarified.

Ace glanced at the white cross on his flank then looked back at Snow. She felt the capillaries upon her cheeks dilate in excited emotional response to that stare. She felt… different in front of those sad eyes.

“Do you comprehend?” she finally asked. She invited the reddened state her face had become.

“You love me?” Ace finally inquired.

“You are not responding to the question I asked. Do I have to repeat my sister’s words?”

“Oh, yeah. I mean I understand. I think I’ll be ok,” Ace struggled to say. “It was just kind of unnerving. We never found out why.”

“Yes.”

“Hmm?”

“It appears I am developing a love-based reaction to your presence,” Snowheart said with a little quiver. She did not like the feeling of shame or embarrassment. She was always forthright and honest, yet for some reason, admitting this to him had been more difficult than informing a patient of their imminent demise.

“Wow, it just felt like a one-eighty here,” Ace said, scratching the back of his neck. “I mean, I love you too. Just odd to come off of one of the goriest scenes Ii’ve been at and hear it for the first time.”

“No,” Snowheart sighed. “It is common. Within our profession these scenes will occur. There will always be a pony in trouble that we can not save. But there is balance. There are always more pleasant things that can spur our emotions forward. Things like love. “

Ace hugged his nurse and she returned it. “I think I feel better now.”

“If you wait until my shift has completed we can return to my domicile together. We can rest together in this new blossomed physical experience.”

Ace’s face turned red but he nodded. “I’ll, uh, wait in the crew room.”

Snowheart nodded in affirmation. Then turned and trotted back to her post. She glanced at the clock in the wall. Her break was over.

“Welcome back, Snow, did you have a good… whoa,” Tenderheart cried, staring at the logical pony.

“I was useful,” explained the nurse.

“Your face is so red right now. Did you, uh, uplift your boyfriend?” Tenderheart’s tone betrayed another double entendre. As did the wide smile that spread across her face.

“He is much better,” Snowheart agreed.

“I’ll bet. So, uh, how was it?”

“What you are insinuating has not occurred.”

Tenderheart giggled. “I know. I was just…”

“But may occur tonight,” added the stoic pony.

“What?! I was just a.. I didn’t mean…” stammered the flushed younger sister.

Snowheart turned and looked at her. A small smirk graced her face.

“You…” Tenderheart threw her hooves up in disbelief.

Snowheart remained smirking as the other nurse was called to deal with a patient. She found herself smiling the rest of the night.