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It was hot. God, it was hot.
That was all you could think as you pulled onto the bridge, the air conditioning in your car doing absolutely nothing against the ninety-five-degree weather. Pittsburgh was boiling. A massive heatwave had rolled through the city, and even though you’d seen it coming days ago when the temperature was barely scraping seventy, mentally preparing for the heat hadn’t sufficed. After twenty-three summers of loathing the humidity, the heat still managed to hit you like a physical blow.
The vents blasted harder, fighting a losing battle, and you mentally cursed yourself for not taking out a loan to buy a newer car with better A/C. The speedometer sat squarely at twenty-seven. Knowing the windows would only provide temporary relief before they’d start working against the air, you pressed the button anyway. You let out a breath as a rush of heavy wind hit your face.
“God,” you groaned, tilting your head back against the headrest.
The streets were relatively quiet, but it was barely three in the afternoon, and most people were still trapped at work. In some twisted turn of fate, your boss had let you go three weeks ago, after only fourteen months on the job post-graduation. Not that you’d wanted to stay at that arts center forever. The role of gallery assistant and events coordinator had zero room for growth, but it had paid well enough for you to build a modest nest of savings. Now, your unemployment felt a bit like being pushed off a cliff while knowing there was a mattress waiting for you at the bottom. You’d be fine for a few months; the math on your savings and your upcoming unemployment checks proved that, but the fall was still terrifying.
You were entirely stuck. The four-year degree you’d worked so hard for had started feeling like a mistake halfway through undergrad, and by the end of your time in school, you weren’t even sure why you’d picked it in the first place.
Commitment had always scared you. It was the reason you’d spent all of high school paralyzed trying to pick a major, but of course that same fear of change kept you pursuing a career you no longer felt passionate about. Every day, you’d grown a little more jaded. Every day, you’d daydreamed in class about what your life might have looked like had you been a little more confident, a little braver. Instead, you’d let yourself freeze, swallowed by the sinking feeling that it was just a little too late to pivot.
Change had meant uncertainty, and your interests had pulled you in dozens of different directions at once. Some days, you didn’t think you knew yourself well enough to describe your personality to a stranger. Others, the sheer intensity of your hyperfixations felt like your most defining feature.
You weren’t sure you had the mental fortitude or the confidence to choose a different path and stick to it, so you’d stayed on the wrong one. And now, at twenty-three, living in a new city two hours away from family, you were unemployed with zero career prospects and absolutely no intention of using your bachelor’s degree. Fucking great.
You pressed harder on the gas pedal, the needle inching toward thirty. The speed limit on the Rachel Carson Bridge was twenty-five, but Pittsburgh traffic flowed however it wanted, and you didn’t have the energy to care about being passed by aggressive drivers who found going three over the speed limit equivalent to walking to their destination.
Bridges made you uneasy. Well, driving in general did, but the height and seeming insecurity of this particular bridge didn’t help. It was safe, you knew, but why the fuck did it have to look like it was floating?
For a brief, morbid second, you wondered how long you’d be able to hold your breath if the bridge collapsed and you fell into the river below.
Then, a blur of black and silver whooshed past your window.
Fucking motorcyl-
You couldn’t finish the thought.
An oncoming sedan swerved sharply, smashing clean into the bike. The motorcycle tilted, sparks flying as it slid across the asphalt directly in front of you. Its rider went down with it, pinned beneath the crushing weight of the heavy metal as it skidded twenty feet down the bridge.
You slammed on your brakes, tires screeching as you narrowly avoided the black sedan. The car spun out, coming to a halt in the middle of the two lanes, its crumpled front end tilted toward your bumper.
You couldn’t think. Hands shaking violently, you turned on your hazards, unbuckled your seatbelt, and grabbed your phone. Your heart hammered against your ribs as you flung the door open and sprinted out into the oppressive heat.
“What the fuck were you doing!” You screamed, your voice cracking, louder than you ever intended it to be.
The driver of the sedan was starting to climb out of his car, but you couldn’t focus on him. Your eyes were already locked on the wreckage ahead.
You ran, feet moving faster than you could process. Metal slid across the asphalt, smoke billowing from the engine of the silver and black motorcycle, as the heavy bike slid from atop its driver, where it’d been pinning him down. A black helmet rested untouched at the side of the bridge.
And blood. So much blood.
It was spurting from the driver’s right thigh. Rhythmically, nearly to the same beat of your own heart, as if spraying from a pressurized gun. Spurting. The word repeated in your head on a horrific loop.
If it spurts, it’s the worst, an arterial bleed. A tourniquet is what you need.
The stupid rhyme from the first aid app played in your mind like a broken record, a remnant of a late-night medical drama binge months ago that had left you with a severe frustration that you still weren’t brave enough to pivot.
“Fuck, it’s an artery,” You muttered, throwing your entire body weight downward, slamming your hands onto the wound. Hot, crimson liquid sprayed across your face, coating your fingers instantly.
The man started up at you. His intense brown eyes were wide, wrinkles curling at the corners in pure agony. Short brown hair, a salt-and-pepper beard…god, stop looking at his face and focus! “We need a tourniquet!” You shouted, locking eyes with the driver of the sedan who had hit him. “Give me your belt. Now!”
There was no room for politeness. This man’s blood was emptying itself out onto asphalt. If you couldn’t muster up any of the medical information you’d memorized for seemingly no reason, he’d be dead in sixty seconds.
The driver unfastened his belt with trembling hands and shoved it toward you. You jammed the leather high on the victim’s thigh, right by his groin, and yanked it as tight as your quivering hands let you.
“This is going to hurt, I’m sorry,” You gasped. The apology was useless; the man’s eyelids were already fluttering shut.
“I can’t get it tight enough.” The words choked in your throat. His blood was still dark and hot, spilling out even with the pressure of the leather. You needed a windlass. A lever. Anything to tighten the makeshift tourniquet.
“Fuck!” The driver screamed, pacing on the yellow lines of the bridge. “I fucking killed a guy! I’m going to jail!”
You tuned him out. Your eye scanned the debris. Shards of plastic, shattered glass — there. A small heavy metal wrench from the bike’s tool kit lay a foot away, shining in the boiling sun. You lunged for it and slid the metal bar beneath the loop of the belt.
Then, you twisted.
The leather dug brutally into his thigh with every rotation, but you couldn’t stop.
Round. And round. And round.
On the third spin, the heavy gush slowed to an ooze.
On the fourth, the belt was squeezed so tight against the man’s thigh that the wrench barely budged.
On the fifth, you physically couldn’t turn it another inch. The bleeding stopped, and you breathed out a prayer to a God you weren’t sure you believed in.
“Call 911,” You ordered, your muscles burning as you clamped both hands around the wrench to keep it from spinning out and undoing your handiwork.
You didn’t hear the driver dial. You didn't hear the operator. You could only hear the roaring pulse in your ears and the weak breaths of the man beneath your hands.
“Shouldn’t we move him out of the road?” The driver asked, his shadow briefly covering you from the scalding of the beating sun.
“No, he could have a spine injury.” Your voice was clipped and breathless. “Kneel down. Put your palms on the sides of his head, covering his ears. Don’t pull on him, just support.”
The driver dropped to his knees and obeyed, and for a brief moment, you were shocked that he had listened. When he set his phone on the pavement, the time caught your eye: 3:17. Tourniquets had a ticking clock on them. Every moment meant dying tissue in the limb, but amputation was better than a casket. You prayed that EMS was close as you realized, with a spike of anxiety, that you had no idea “too long” for a thigh tourniquet actually was.
Your hands trembled violently against the warmth of the metal wrench. The midday sun beat down in scorching waves. You didn't notice the sirens until the ambulance skidded to a halt beside you. You barely heard the rushing footsteps and the heavy thud of a trauma bag when it hit the deck of the bridge.
“Motorcycle vs. sedan! Looks like a slide, no helmet!” A paramedic shouted to her partner, dropping beside you. Her fingers pressed into the man’s neck, checking for a carotid pulse, before sliding down to his foot. “Pulse is absent at the dorsalis pedis, good. The femoral artery is locked down. Capillary refill is non-existent. Get the CAT!”
“I-I tried to do a tourniquet,” you stammered, your jaw tight, your voice sounding foreign to your own ears. “It looked arterial, and I just-”
“You did great. We’ve got him from here,” The paramedic interrupted as her partner pulled a black combat tourniquet from the bag to replace your makeshift one.
You let go of the wrench and stumbled backward onto your feet, as the weight of the scene hit you. His bike was clearly broken, his tools splayed around the deck. His blood painted the road, painted you. It was on your arms, your hands, your clothes, sticky and drying on your face. A quantity so large it made nausea roll through your stomach.
You blinked, and the paramedics had a C-collar on his neck. A breathing tube down his throat to secure his airway too, you thought. "Ma'am, you're in shock. Let's get you sitting down," the male EMT spoke as he took hold of your elbow. You couldn’t process his words. You numbly followed as they wheeled the spine board into the back of the rig.
The heavy doors of the ambulance slammed shut, and in the blink of an eye the truck was swerving through traffic. You gripped the bottom of your seat, the motion making you sick. The sirens blared overhead, and you swore you could feel the vibration of them through the metal floorboards. The paramedics worked in a blur over the man. You swore you heard them calling him Robby.
“Time?” A medic called out, looking at you. “Do you know what time you locked down the bleeding?”
“Uh, 3:17,” You whispered, shaking your head. “I put it on him at 3:17.” The numbers felt burned into your brain.
The ride was a blur until the doors flew open, and a wave of balmy Pittsburgh heat hit your face. Pittsburgh Trauma Medical Center, a sign above you read.
“It’s Robby!” A blue-eyed doctor gasped, sprinting alongside the stretcher as they rolled him through the automatic doors.
The paramedic followed closely, rattling off the medical report as they rushed into the trauma bay. “Level 1 Trauma. Unconscious, GCS scale is 7, intubated in transit for airway protection. Tachycardic at 130, BP is 85 over 40. Motorcycle vs. auto, suspected collision at thirty-five miles per hour. Massive penetrating trauma to the right medial thigh with a ruptured femoral artery. Bystander applied an improvised windlass tourniquet at the scene. Total ischemic time for the limb is twelve minutes!”
The doors of the trauma bay swung shut behind the stretcher, cutting you off from the swarm of doctors and nurses. Inside, the room exploded into chaos. You could hear the sharp bark of orders through the glass.
Through the narrow window, you watched a nurse wheel in a massive machine infuser. Within seconds, they were hooking the man up to it, pumping units of blood into his body at lightning speed as they checked over his injuries.
Before you could take another step forward, a curly-haired man in scrubs gently blocked your path, nudging you out of the sterile bay.
“Ma’am, you need to step back. They’re preparing him for the OR to repair the artery,” He spoke, his voice tight; you could see the terror in his wide eyes. He didn’t wait for your response before rushing back into the chaos.
You were left standing frozen in the middle of the bustling hallway. You looked down at your hands. They were covered in his blood. It was drying sticky on your skin, crackling as you stretched your fingers apart before tightening them back into a fist. Your clothes were ruined, the heavy, metallic scent thick in your nose.
“Hey. Come with me, miss,” a gentle voice said.
The blonde nurse with tired eyes placed a warm hand on your trembling shoulder, guiding you away from the chaos and into a small, quiet exam room. She got to work, checking your pulse, shining a small penlight in your eyes, and assessing you for shock or any hidden injuries. She looked older than you. Around the age of the dying man, you guessed.
“What’s your name, sweetheart?” She asked softly.
You forced your mouth to open. Your throat felt like sandpaper. You managed to choke out your name.
“I’m Dana,” she responded, her eyes shining with gratitude. “And it seems like you might’ve just saved the life of this ER's attending, Dr. Robby.”
You nodded, unable to focus on her words as she reached for a small stack of fabric, handing you a clean hospital gown and a pack of sterile wipes. “Here. Let’s get you out of those clothes, hon.”
You began wiping the dried blood from your skin. Beneath the lingering adrenaline, a deep, heavy frustration settled within you. You were angry. Why wasn’t he wearing proper gear? Why didn’t he have a helmet on? If he had just worn thick riding leathers like you knew motorcyclists were supposed to, if he hadn’t been so reckless and passed you going ten miles over the speed limit, he wouldn’t have crashed. You wouldn’t have been forced to hold his life in your hands.
Even still, as you scrubbed the stains from your hands, his face refused to leave your mind. The sharp line of his jaw, the salt-and-pepper beard covering it, the way his intense brown eyes had stared up at you in agony as he lay on the asphalt, as if pleading with you to save him. You had pulled a man from death, and all your mind kept coming back to was just how striking he was.
Your mind reeled, the reality of your situation hitting like a physical blow. You were twenty-three years old, completely lost, and currently sitting in a trauma center covered in a stranger’s blood. Deep down, you felt small, unsure, and entirely unqualified for adult life, and yet, your hands had stopped an arterial bleed just fifteen minutes ago.
Your hands still shook slightly when Dana walked back into the examination room, but your breathing had evened out as if a calm was beginning to settle in your chest. You knew that you had done everything in your power to provide care to Robby. Even if your hands had been trembling and even if you weren’t sure of your footing, you had done it right.
You tied the gown behind your back and looked Dana in the eye. Your voice was steady now, and you were surprised by your own determination. “I want to see him when he gets out of surgery. I'd really like to see him.”
Dana offered a small, knowing smile and nodded softly. “I’ll make sure someone comes to find you when we get word that he’s stable. You did good, kid.”