Gabriel

          As soon as I felt the chill of the hard orange plastic seat through my paper-thin scrub pants, I wished I had changed back into my crumpled khaki pants and blouse, which were now squeezed in my backpack in front of the massive pathology textbook I hadn’t had a single free minute to study. It was my second year of medical school, our exam on dermatology was in three days, and I still had dozens of rashes to memorize, but I was too exhaust to wiggle the book out of my bag and open it. The metro car would have been perfect for studying too, given that I was the only one on it at 10:25pm on a Tuesday in the gloomy winter. It had never occurred to me that my quarterly afternoon of shadowing a gastroenterologist at the far outreaches of the northeast suburbs would turn into a whole night of tailing after her seeing inpatient consults, observing an emergent colonoscopy with such a unique smell I almost passed out, and then listening to an extremely thorough 45-minute lecture on inflammatory bowel disease.  I had probably learned something from it, but mostly it had served to remind me of how much more clinical medicine I had to learn before our hospital rotations began in four short months.

              While making a mental checklist of what I needed to review before class the next afternoon, I was brought back to the dank metro car by the entrance of a disheveled man and woman. Earlier in the winter, a morning commuter had been stabbed by a man having a psychotic episode, which immediately popped up in my mind upon seeing these two people. I was disappointed that no one else followed behind them to get on the same car, leaving the three of us alone as the doors screeched closed. I was seated in a raised section, and they were in the lower middle part of the car, far enough away so I couldn’t hear what they were mumbling but close enough so I could smell a putrid mix of body odor and mold. Deciding to stay still and avoid eye contact, I gazed out the rain-coated window while watching them in the reflection of the scratched plastic.

              To my disbelief, after sliding down to a sitting position on the filthy floor, the man rolled up his sleeve and took out a stretchy blue rubber band. He tried to tie it around his left upper arm, but his right hand was shaking too hard.

              “Help me, come on,” he said urgently to the bedraggled woman. Deftly, she secured the tourniquet on his arm and retorted “I supposed you want me to dose you too?”

              “Hell yeah I do,” he replied.

              She shifted her back to the window, making it impossible for me to see exactly what she was doing, but I could only assume she was injecting him with drugs. A minute later, he groaned in pleasure, then suddenly fell away from her onto his side, his head hitting the floor of the car with a dull thud. 

              “Ah shit,” she muttered loudly, slipping something from her closed hand into her pocket before squatting over him and shaking his shoulder. It felt as if the air had been sucked out of the car. Had he overdosed that quickly? Heart attack? Massive stroke? How did drugs kill people anyway? Glancing around the car furtively, she noticed me for the first time and made eye contact. Even from 15 feet away, her eyes betrayed her immediate and accurate assessment of me as completely useless and unwilling to help. With a sneer in my general direction, she turned away and went back to shaking him and yelling “Gabe! Come on man, wake up!” while slapping his face. Terrified, I realized I should call 911, but was worried about calling her attention back to me and being accused of snitching on them.

              The metro rolled down the bridge and slowed, nearing the next stop. The woman looked like she had given up on Gabe and was instead fumbling frantically in her torn, filthy red backpack. Finding what she was looking for at least, she pulled out a small vial, sprayed the contents in his nose, and darted off the metro the second the doors opened. Through the drizzle, I could see her sprinting down the street while an animalistic roar arose from Gabe, who began to flail on the ground. What had she sprayed in his nose? Was it some kind of hyper-methamphetamine, an upper to counteract the downers they had injected? I picked up my phone from my lap and dialed 911 with trembling fingers.

              “911, what’s your emergency?” I heard before seeing Gabe on his feet, moving towards me.

I dropped my phone, got up and positioned my bag in front of myself, and started trying to back away, holding onto the back of the seats for balance as the metro lurched on.

              When the doors opened at the next station four police officers rushed onto the train. Two grabbed Gabe, who thrashed but didn’t put up any significant or coordinated resistance, one swept the other end of the car, and one approached me, taking in my scrubs and holding the vial in his hand.

              “You saved his life you know,” the stout officer said. His badge said Officer Sylvester. “He’s never going to thank you, but you did. I lost my mama to a heroin overdose, so I’ll say thank you on his behalf. I can’t believe his luck that there was a nurse in this car who happened to have Narcan with her.”

              As the two officers continued firm guiding Gabe off the car, the third, Officer Bradley, joined his partner in front of me. “We just happened to be leaving a scene around the corner when dispatch called it in based on your phone location. You must have known these guys wake up combative after you reverse their high, but you were brave to do it anyway. With how out of it he is still, no way he would have kept breathing until the next stop.” 

              I remained too shocked to speak. Undeterred by my silence, Officer Sylvester continued. “You look like you’ve had a long night. Want a ride home? I even have an extra chocolate glazed in the car if you’re hungry.”

              I nodded, my pulse still racing.

              “Where do you work?” he asked. “I don’t recognize you from Harborview ER, I know all those nurses too well.”

              “Um… I’m a med student. At UW.” I stammered.

              “Damn Bradley, you hear that?” he boomed, despite Bradley’s position directly next to him, writing on a pad. “A med student! They teaching you guys well. Let me have your name, I want the school to know you just saved a life.”

              Still in shock, I gave him my name. Expecting to have to give an official statement, I was surprised when Sylvester handed me my cell phone, which he must have picked up at some point, and guided me to his car. He made small talk the whole drive home, mostly to himself, and waited at the curb until I had unlocked the door and given a sheepish wave. 

              With a shiver, I suddenly realize how swept up I had been in re-telling that story of a dreary night 10 years ago, a bit alarmed at how easy it was for me to remember the fear and helplessness I had felt. My interviewer, an earnest journalism student interning with the local news website, finishes scribbling a few notes and looks up. She meets my gaze now that I’ve mentally returned to the conference room in the back of the opioid treatment center I recently opened, Gabriel’s Place.  

              “I haven’t ever told this story before, you know,” I say to her. “I always felt guilty about being hailed a hero, but was too insecure to correct everyone once the story spread, and then it was just a thing in the past, a little feel good blip of a news story that didn’t seem worth talking about. But after that night I re-committed myself to medicine and vowed to never be afraid to try to help someone who was struggling.”