Page 488 of End Game

There is a particular sound an ambulance makes backing into an emergency department bay.

The diesel.

The reverse alarm.

The change in engine pitch when the driver lines up with the doors.

I've heard it thousands of times.

Tonight it sounds completely different.

A team of nurses and one resident is waiting. I listen as they go through the report they already have.

Likely DKA.

Altered.

Type One.

Glucose beyond the range of the home meter and EMS glucometer.

Tachycardic.

Tachypneic.

Fluids running.

The charge nurse stands beside me—she knows who I am and why I’m here.

That might be helpful.

Someone from registration is hovering back far enough to stay out of the way.

I know everybody's job.

I know exactly what happens next.

And, yet, my hands will not stop shaking.

I cross my arms to try to stop them.

The ambulance turns into the bay.

Backs toward us.

Too slowly.

Then too quickly.

The brakes hiss.

The rear doors stay closed for maybe three seconds.

Feels like thirty.

One opens.

Then the other.