"Sinai. Go with your traffic."

"Sinai we're enroute with a 47 year old female, unresponsive. She was found on the sidewalk. Bystanders state she's been drinking all day. Her vitals are stable and we've got an IV established. Our ETA is about 5 minutes. Anything further?"

('Anything further' - well, you could maybe divert to another hospital, maybe another state or just take her home and let her sleep it off.)

"Nothing further, thirteen. We're eagerly awaiting your arrival."

I'm in Triage, the entry point to the ED. Triage means "to sort" and it was originally used on the battlefields of Europe where the salvageable where separated from the dead or nearly dead. Now days,however, we aim a little higher. Every cough, sore throat, abdominal pain, STD and gunshot wound comes through triage. The object is to sort out the truly sick from the whiners, malingerers and assorted regulars who think of the trauma center as their home base.

Triage nurses need special skills. They have to listen intently, ask pertinent questions and observe the unspoken. They have to handle the two ambulances behind them, the sore throat in front of them, the family plan at the window checking in, the doctor on the telephone who wants to tell you about his extra-special patient and the other person at the window wanting to know "why it's taking so motherfuckin' long because they have to get back home 'cause the kids are by themselves and the ten year old's watching the baby." The Triage nurse has to know what beds are open, what's coming in, who has to go where and be ready in case somebody dumps a knifing off at the door. Triage nurses need equal measures of compassion and skepticism. A sense of humor, however warped, is a must.

The automatic double doors whooshed open on the familiar sounds of stretcher wheels on tile; the sound of ball bearings mixed with sand in the key of F-sharp.

"This is Mabel and she hasn't woken up for us yet. This is only the third time we've picked her up this week."

Mabel is, indeed, a regular and has that particular cheap wine and piss smell common to bust-out drunks. It's never a good thing when the ED staff knows you on sight and Mabel was known to us all. I write the pertinents, re-do the vitals and try to wake her.

"Hey! Mabel! You in there?" A shake and shout elicits a mumble. In a few minutes, my paperwork done, I move to accompany the squad to a bed in the back.

"Room Nine for Sleeping Beauty."

But as we roll, Sleeping Mabel begins to awaken.

"Where am I? What's going on?"

"I'm sorry, Mabel, but we did everything we could." I sound sad, sincere, apologetic. "But you died and we're taking you down to the morgue now." That wakes her up.

She wails, "I don't wanna be dead!"

"I know, hon. Nobody wants to be dead, but we did everything we could. I'm sorry."

"I don't wanna be dead."

The medics keep straight faces as we roll past other rooms, patients standing in doorways, wondering when they're going to get seen and looking at the not-dead woman.

Mabel was put in the bed, examined, tucked in and went home in the morning. She spent the night sleeping it off. Sleeping, as it were, the sleep of the dead.
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