P.E.R.L.

"I'm going to shine a light in your eyes now. I need you to look at one spot over my shoulder....."

"Pupils Equal and Reactive to Light." says the nurse with the bloody scalp wound.

She fell from standing on her bed and hit her head on the way down. She denies losing consciousness but I assume nothing.

"Yes." I say apologetically, "You know I have to check you out."

She sighs and smiles. Together, we go through all of the normal neurological tests for someone who may have a possible brain injury. She calls out their official name, what nerve they test and what it means to the examiner while I perform each test. Her neighbors got a really good education in neurology.

She passes every test. She looks me in the eye.

"I'm not riding in your ambulance."

I look at the blood trail down the stairs to the kitchen where we met her. I raise one eyebrow.

"You know scalp wounds are bleeders. Besides, My friend, Cindy, will be taking me to the urgent care center."

I want to talk to "Cindy."

Quick as a flash and without any confusion, She picks up the phone, dials, explains what has happened and then hands me the phone.

"This is Cindy."

Yes, it's Cindy. Yes, she's on her way. Yes, she knows where she's going. Yes, she's a critical care nurse too.

This is a patient refusal that I don't feel too bad about.

Good thing too. All of the hospitals were on Re-route. With a patient who's vitals were within normal ranges, we would have waited for hours, I'm sure.

"I saw you playing drums at open mic night at the Café last time. You're good, man." says a neighbor to me.

I love hometown EMS.

--maddog.