Rule number one is to lay it on thick
              for anybody that asks about what you do.
This way you’ll seem brooding and dark,
              like you maybe know something that they don’t,
when the truth is that you’ve got permanent
              circles under your eyes from lack of sleep,
that you make fourteen dollars an hour, and you’re getting
              fat from a steady diet of gas station food and Redbull.
But you still gotta act like you’re someone special,
              because rule number one is to always appear in control of the situation.
Walk. Never run. Never run unless you’re getting shot at
              or some drunk fratboy in his daddy’s Lexus
is about to slam into the MVA you’re working,
              because dodging cars is a lot harder than dodging vomit—
which brings me to rule number one: always bring an extra uniform.
              Bring your own rain gear too, or you’ll wind up realizing
that the rain pants you borrowed from your partner are a size too small
              when you rip them from ass to crotch at the scene of a high-speed wreck,
which just happens to show up on the local news;
              and there you are, front and center, looking like
just the kind of guy that any caring mother
              would dread seeing beside her son trying
to resuscitate him, a head-on with partial ejection.
              So get a pair of rain pants, maybe Marmot or something
and do your job and don’t fuck it up. Guess what though?
              Rule number one is that eventually, you will fuck it up.
There will be a moment when there is absolutely nothing you can do,
              when all your training becomes suddenly and completely useless,
and just like that you’ll be demoted to Bystander,
              and you won’t want to watch but you will,
because being a witness is part of the job,
              maybe the hardest part, but also maybe the most important,
and it may be you remember the kid from that wreck
              for a long time, remember the way his mom said his name,
that his tube was a 7-inch, that you gave 4 epi’s
              and shocked him as many times
but he was still in arrhythmic and eventually his ribs
              cracked under your hands during compressions.
At these times it is best to recall rule number one,
              which is that everyone dies,
and you can’t take it too hard when it happens.
              You showed up and you tried and that’s all you can do;
you just gotta remember to keep things in perspective,
              because at night when you walk out of the ER,
the city’s tall lights reach up
              to kill the stars.
Long wet ellipses
yawn some question
asked and given up.
I wash the wound with saline
and pull pleated skin
together to cover up the nakedness.
The delicate red muscle,
the exposed tendons
I can now watch
move wetly back and forth
to animate carpals and metacarpals
when I ask please move
your fingers, please
squeeze my hand,
and can you feel me
squeezing yours.
Too young
for Ativan but we sit quietly
despite the pain
while I read the report.
Pages unfold under my hands,
coming apart, between them
a concise narrative of abuse.
The boy’s eyes are wet
new-polished stones,
between their folded lids
my barely-opaque reflection
trapped in the glassy surface,
and whatever waits
in the clouds
moving darkly behind it.
Avoiding his gaze I look out
the ambulance window—
my face there too,
hard, also stone,
obsidian-black but translucent
when held to the light,
held fast now,
as the city’s glow cuts
through the dark
world of night moving
beyond the glass.

Luke Patterson
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