Chapter One

Chapter One  ·  Oliver / Travis The Devil's Ledger

Hostage Call

Denver. A barricaded call. Two men are dying on the floor, there's only one ambulance, and there's no right answer. What begins as a night shift ends with a feeling Oliver can't push out of his head: "You don't practice healthcare anymore. You process risk and call it care."

Lying on the carpet to his left is a man who just did the unthinkable. Two feet to his right — a cop. People think that in moments like these that everything slows down, but they're wrong. It doesn't. Everything actually speeds up, collapses in on itself, and is over before the brain can process what just happened.

The room Oliver Adams is standing in is still ringing with the aftershock of the point-blank gunshot, his pulse jackhammering in his ears while everyone around him moves like dispatch audio being played back at double speed. Voices are stacked on voices, boots are scraping on the floor, and someone is shouting his name from what feels like very far away.

The man to his left took a round to the head -Oliver can see that from across the room and all over the walls. The man to his right is a cop with what sounds like a sucking chest wound, and he's still moving. Both men are someone's son. Both once got cake on their face and blew out birthday candles while their families smiled and sang.

Oliver moves to the left first.

Shit.

"Scott?"

"Are you kidding me?"

"Nope."

Oliver lifts the man's chin and performs a quick primary assessment — running through the ABC’s. He’s moving air through his airway, A. He’s breathing, B. And he has a pulse, C.

The wound from the bullet above his ear is stained dark from the soot of the gunpowder. His breathing is shallow and rattling, but it's there. Oliver doesn't need a CT scanner to know what the bullet did on the inside. But his chest is still rising, which means his heart is still moving blood somewhere.

His body is fighting stupidly and stubbornly.

Then Travis Rawlins's right hand moves.

It isn't voluntary, Oliver knows that. It's the kind of motor response that falsely means everything to a family and nothing to a neurologist. His fingers curl slowly against the carpet like they're trying to grip something that isn't there. Oliver watches it for exactly one second.

A radio crackles on the shoulder of Oliver’s partner, Paramedic Scott Hollis.

Oliver looks up.

Scott eyes meet his. "That’s our backup."

The chaos in the room doesn't diminish. The blood on the walls doesn't dry. The two men on the floor don't get up. This is the scenario that Oliver is in: there’s only one ambulance, the two men are both technically still alive, and he can only do one thing at a time. Does he choose the left door or the right? The red pill or the blue pill?

He looks at the Rawlins on the floor to his left, then over his shoulder at the cop on his right, panting through gritted teeth with pink foam gathering at the corner of his mouth. He quickly does the math paramedics do on mass-casualty calls like these and decides which patient will benefit the most from the two sets of hands in the room.

The math here is simple. It's also the worst math Oliver has ever had to do, because in this version, both answers are wrong, and the only variable of this equation that isn't is time. He can still hear Rawlins's voice through a hollow-core door echoing in his mind.

Another cop’s voice cuts across the room like a blade.

"Adams!"

Oliver doesn't move. The bad guy's chest rises, then falls, then rises again. But paramedics don't let cops die. Oliver looks at the seeping wound tracking across the cop's chest and makes his decision.

No pressure.

But there is pressure — a lot of it — and the room is suffocating in it.

He focuses on Denver Police Lieutenant Chris Gibbs without asking permission from the part of his brain that will later question all of his decisions. This is triage medicine down to its bare bones, and Oliver hates calls like these because he has to play God and choose who lives and who doesn't. Who is he to make a decision like that? Who is anybody?

"Hey, Gibbs. Look at me."

Gibbs tries. His eyes find Oliver's for a beat, then they drift away. The pink foam dripping out of his mouth is clinging to the corner of his lips.

"He's crashing," Oliver says.

Scott has Gibbs's arm extended on the carpet and is already taping the IV line into place. "First one's in."

"Good," Oliver says.

Oliver wonders whether Scott knows that he is scared out of his mind right now, or if he knows that he’s really curious about who will clean all that blood off the blinds when they’re gone.

Oliver thought that he'd already seen all the darkest corners the job had to offer. Yet, once again, it seems he's been proven wrong.

A crack of the wood floor under someone’s boots shakes something loose in Oliver’s mind and time rewinds a little.

Not but a moment ago, Scott and Oliver were stacked outside the apartment door in a dingy hallway next to two extremely huge cops stuffed like sausages into their uniforms. Officer Chris Gibbs was standing in the center of the door frame, Officer Scott Carey was on his left, and Oliver stood just to the right of both of the men, excited to see someone get tased.

Seeing people get tased is one of the perks of the job.

He remembers yelling, "Travis," through the hollow-core door. "My name’s Oliver. I’m a paramedic."

Then there was a sudden movement inside and a voice that answered.

Oliver glanced at Gibbs, then back at the door. "I’m with the ambulance."

For half a beat, they could only hear his breathing on the other side of the door. And not the breathing of a man calming down, the breathing of a man trying to decide whether the voice on the other side of the door belonged to a person or to the thing that has been talking to him all night.

Then Travis Rawlins said, "You know what they’re calling it now?"

"What?"

"Resource optimization."

Officer Carey shifted beside his partner, obviously not patient enough to coax the man out politely.

"Travis, unlock the door. Now."

But Rawlins kept talking, his voice was closer now, right against the other side of the door.

"They’ve already flagged me," he said. "You know what the flag says? 'Denied: Low-yield patient’. Like I’m a crop. Or a bond. Like I’m a row on someone’s spreadsheet."

Something cold moved through Oliver. He had no place to put it, so he did what medics always do when a scene starts slipping sideways — he narrowed his world and focused on the patient.

"Travis. Open the door and let us help you."

"Help me?" The laugh that came through had no humor in it. "You'll just log me. Route me. Delay me. Push me somewhere cheap and call it care." Gibbs gave Oliver a look that said he'd had enough and started to move, but Rawlins spoke one more time, quieter, almost to himself. "You don't practice healthcare anymore. You process risk and then call it care."

The lock snapped open.

The door flew inward, and Travis Rawlins came through it like a wrecking ball.

He didn’t look at the cops or the tasers they were holding.

He went straight for Oliver.

Rawlins grabbed a fistful of Oliver’s uniform and pulled him forward into his apartment hallway wall, hard enough to rattle the dusty light fixtures in the kitchen. The other two cops pushed in from the entryway and tried to tear them apart, but Rawlins kept dragging Oliver with him like he had been picked as the one man in the room that he wasn’t going to let go of.

Gibbs grabbed the man and tried to wrench him away from Oliver, and for a split second, the outside hallway opened up between the cops and presented a clean path of escape for the man.

But he didn’t take it.

Instead, he lunged forward again, both of his hands this time reaching for Oliver’s uniform, like that was the only thing in the room he cared about.

"You don’t even know that you’re part of it," Rawlins snarled, dragging Oliver sideways into the wall hard enough to blur the light.

"Part of what?"

Rawlins’s eyes were huge, bright, and fixed on Oliver’s paramedic patch like it meant something different to him than it did to anyone else in the room.

"Their lies," Rawlins said. "Their no’s."

Rawlins’s grip tightened on the front of Oliver’s uniform like he was trying to pull him close enough to whisper in his ear through all the noise.

"You’re not one of them yet," Rawlins said. "You may not remember me, but I remember you and your kindness."

Oliver barely had time to register the words before Rawlins’s bloody hand slid down across his chest, fingers fumbling hard against the front of his uniform shirt near the pocket seam. It felt less like a strike than the desperate shove that it was. The movement felt deliberate, but was buried in the violence of the struggle.

Oliver jerked backwards on instinct, thinking that the man was reaching for his radio, his pen, his throat, anything.

Then Rawlins’s hand was gone.

His mouth opened again, his breath hot and ragged, his eyes still locked on Oliver.

"Don’t let them win."

Then Gibbs crashed into him and the room came apart.

Then, with about as much warning as before, the memory broke apart in Oliver’s mind, and he found himself back in the present kneeling over Officer Gibbs.

Scott is moving so fast; his shirt is soaked with sweat, and his jaw is clenched tight.

A firefighter approaches and drops to a knee with the heart monitor case already open, his hands hovering over the defib pads like a kid about to touch a hot stove.

"No," Oliver says without looking up. "Those won’t help. I need my trauma bag. Now."

The firefighter blinks once, then bolts down the hall. Oliver hopes that he’s going to get his bag and not running away forever.

Security stands there as useless as furniture.

All hat, no cattle.

Officer Carey barks, "Everyone out unless you’re medical," with his raspy, raw voice. He’s still in his tactical gear, probably from some training before, and sweat is beginning to darken around his collar. He’s still holding his 9mm low and steady like his hands don’t know how to stop working, and he just keeps yelling "Move" repeatedly to the stunned room.

The room is awash with dirty emergency lights ricocheting off the walls as the ambulance and cop cars arrive outside.

Officer Gibbs’s breaths are shallow and quick as he pants through his gritted teeth. The bullet that was shot from Gibbs’s stolen duty pistol, and that had once been secured in his holster, had punched a hole above the edge of his bulletproof vest and tracked across his left chest, creating a pool of scarlet blood that is now saturating through the Kevlar fibers into his blue shirt.

The blood seeps out and refuses to stop.

Why can’t he get it to stop?

He wishes it would stop.

Oliver kneels at Gibbs’s shoulder and keeps his own breathing slow on purpose.

"Hey, Gibbs. Look at me."

Gibbs tries. His eyes find Oliver’s for a beat, then they drift away. The pink foam dripping out of his mouth is clinging to the corner of his lips.

"He’s crashing," Oliver says.

Scott has Gibbs’s arm extend on the carpet and is already taping the IV line into place. "First one’s in."

"Good," Oliver says.

Oliver digs out his orange-handled trauma shears from his cargo pocket and cuts Gibbs’s shirt open with them, his hands seeming to forget about the shaking as his muscle memory takes over.

He lifts the bulletproof vest over the cop’s head and sees a small hole in his upper left lateral chest wall. The tattooing from burnt gunpowder and metal scraps from the projectile has created an angry purple bruise just medial to his upper left arm and above the protection of the vest.

The shot couldn’t have been any more surgical, Oliver thinks to himself.

"There it is."

"Left lateral chest, third intercostal space. I don’t see a second hole."

Oliver never says ‘entrance wound’ or ‘exit wound’ because he’s not a forensic examiner. And, regardless of what you call it, a hole is a hole.

Oliver plants a chest seal hard over the hole, pressing his palm flat into the bleeding chest. Then, he grabs his stethoscope and listens to Gibbs breath sounds.

The right side sounds loud and present. That’s good news.

The left is thin and fading, like the air is getting trapped, and his lung can’t keep up.

Gibbs’s skin is going pale in a way that Oliver doesn’t like.

The pulse at his wrist is fast and weak.

"Where does it hurt?"

Gibbs tries to answer but coughs instead. More pink foam spills out of his mouth.

Oliver glances at Scott.

"I almost have it," Scott replies. He really can read Oliver’s mind, because the question is answered even before he asks it.

Oliver runs his fingers up Gibbs’s neck and feels the veins that are starting to bulge and stand out. His breathing is becoming increasingly labored.

Carey’s voice cuts in from the doorway.

"How we looking, boys?"

"We gotta go," Oliver says without looking up.

Oliver snaps his eyes to the firefighter hovering too close, the one trying to see what’s going on without knowing what he’s looking at. "If you’re going to help, hold the oxygen. If you’re not, back up."

The firefighter swallows and nods.

Oliver rips open the needle thoracotomy kit and holds it up for half a second, to see it, to trigger the old training that lives somewhere deep inside his frazzled brain. Gibbs doesn’t have time for Oliver to talk himself into doing this dangerous emergency procedure. He only has time for Oliver to be correct on the first try.

The firefighter leans in despite himself.

"You sure? That’s a really big needle."

Oliver looks at him, then back at Gibbs.

"No."

Oliver slides his gloved hand under Gibbs’s left arm and finds the spot by touch, counting the ribs under his fingertips until he lands where he needs to be. He wipes the area with an alcohol pad and doesn’t wait for it to dry because clocks don’t care about sterility. He aims the 3.25-inch catheter, a tent stake of a needle, just over the top edge of a rib to avoid the vessels below, and pushes.

There is some resistance, then it gives, and then he hears a sharp hiss, like pressurized air escaping. Gibbs flinches his whole body, and he draws in a deep, satisfying breath, like his body has been waiting for permission to do this for over an hour.

Oliver watches Gibbs’s eyes refocus. His panic doesn’t go away completely, but Oliver can see that some of his fear has been lessened.

"Better?" Oliver asks.

Gibbs nods once. "A little."

"Good."

Scott’s voice comes in tight.

"Second line’s in. It’s wide open."

He is still reading Oliver’s mind.

Oliver tapes the needle catheter on the left side of Gibbs’s chest with fast hands and rechecks the seal, pressing the edges closer to the skin. He grabs his stethoscope again and listens to Gibbs’s breath once more. The left side is still diminished, but it sounds much better than before.

"Let’s go," Oliver says.

A firefighter finally finds his spine and says, "The elevator’s ready."

"Good," Oliver says. "You—" pointing at the least-frightened firefighter, "—hold the IV bag. You—" a second firefighter "—grab the oxygen and the monitor."

A security guard, his voice too loud and too late, nods towards the other man on the carpet. "What about him?"

Carey answers before Oliver or Scott can. "Another ambulance is en route."

And as though the room had summoned it, a radio on somebody’s shoulder squawks that the second ambulance has just arrived on scene. The dispatcher’s voice sounds normal at first. Then she repeats the update in a clipped, careful way that makes Oliver look up.

In error?

The words land wrong. They’re too clean for the blood-soaked wreck of a cop bleeding out on the carpet.

Oliver looks at the other man on the floor and hear’s his voice.

He pushes that thought away because Gibbs is still alive, and he doesn’t have time to think about conspiratorial statements mumbled by a man who just tried to kill him.

But the sentence stays with him anyway.

The second crew arrives quickly and pushes into the living room, looking half-lost and half-guilty, and Oliver see the unpatched trainee first. His eyes are as wide as half dollars as he takes in all of the blood from the scene.

He extends his arm as though he wants to shake hands, "Ethan Ashcroft, sir. Nice to meet you."

Ignoring his awkwardly timed greeting, Oliver grills both him and his field trainer, "What the hell took you so long?"

The field trainer holds up both his hands.

"Dispatch canceled us, dude."

"On an officer down?" Oliver asks, incredulous.

"It’s a mess, Ollie," the trainer says. "Thank God EMS One was listening to the PD radio traffic and sent us anyway."

Oliver looks past him to the trainee. "You hear that? Ethan, was it? If dispatch tells you to cancel on a cop bleeding on the floor, you listen to the radio that matters."

The trainee swallows.

"Yes, sir."

"Good. Now see if there’s anything you can do for him."

Scott and Oliver hoist Gibbs onto the soft stretcher, and he groans like a dying engine. Together they drag the aluminum frame down the hall in a rattling, bouncing sprint. The building seems made up of only ninety-degree corners and really bad lighting. Gunpowder from the shot mixes with the cheap carpet cleaner, and Oliver can taste the metallic tang of blood in his mouth.

The elevator doors open, and two firefighters brace them as if the doors are trying to close on them out of spite. Gibbs’s color wavers between a pale blue and a thin, angry pink. Oliver leans in closely and, with his steady voice in Gibbs’s ear, says, "Your only job now is to breathe. That’s it. Just breathe."

Sometimes, as a paramedic, being supportive matters more than being smart.

Gibbs tries to nod, but it comes out more like a twitch.

As the doors squeak open with a shimmer, the elevator car jolts to a stop and vomits them into the main entrance of the apartment building. Congregating outside the elevator is a pageant of cops in duty blues with their rifles pointed down, because rifle discipline is a religion.

"Move! Make a hole!" someone shouts for Oliver, and the world obeys.

They burst through the lobby doors into the night, and the cold grabs them by the hair. Oliver hadn’t noticed how hot the apartment had been until the cold October air blew on the hot sweat of his sticky neck.

They never run on scene, but tonight, they run.

The ambulance is idling at the curb with its doors open.

"Watch his lines," Oliver shouts while climbing in backwards one foot at a time.

Scott snorts as he swings around to the front of the rig. "He’s going to hate the ride back to Denver General."

"I hate the ride to DG every day," Oliver says.

And for half a second, it almost sounds like they are themselves again.

The algorithm is already running.
Oliver just doesn't know it yet.

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