Frank is mid-shift when the radio crackles with an urgent call to dispatch him southbound on I-5 toward a "Code 3, possible STEMI in transit."

The ambulance shudders as he weaves between traffic, his partner Marcos white-knuckling the wheel. "Here we go again! Another one, and so soon?" he mutters, flicking sirens louder as rain smears the windshield.

In the back, Frank's fingers hover over the AED, already calculating: thirty-seven minutes since onset if the caller was right, twelve since collapse, six since they got the ping. Way too long for chest pain that won't quit.

The staticy radio cuts in: "Medic 12, patient is a 58-year-old male in a gray Honda Civic, license plate Whiskey-Delta-243, pulled over at mile marker 72. PD on scene reports agonal breathing." Frank exhales sharply. Not good.

The Civic comes into view, hazards blinking. An officer waves them down, face tight. "Guy's out cold," the officer shouts over the rain. "Wife says he clutched his chest..."

Frank hits the pavement before the ambulance fully stops, AED thumping against his thigh. The Civic's passenger door gapes open, a woman inside screaming at her husband: "Breathe, Ralph, breathe!" while shaking his slumped shoulders.

Frank shoves past her to check vitals: no pulse, pupils fixed. He tears the man's shirt open with one sharp yank.

"Marcos!" he barks over his shoulder, "We've got V-fib!" The AED pads hiss as he slaps them onto Ralph's clammy chest.

The machine whines, charging. "Clear!" The body jerks, then nothing. Frank pumps two rescue breaths between compressions, ribs cracking under his palms.

"Come on, Ralph!" Regina sobs, her nails digging into the seat fabric. Marcos tosses Frank an epinephrine vial, already prepping the IV line. "Second shock in three," Frank growls, sweat mixing with rain on his forehead.

The AED whines again. "Clear!" Frank shouts. Ralph's body arches, then falls limp. Frank's fingers find the carotid artery. "Still fibrillating," he mutters, resuming compressions.

Regina wails something about grandchildren, her voice dissolving into static under the hammering downpour.

Frank ignores her, counting compressions under his breath, 'twenty-eight, twenty-nine, thirty', before locking eyes with Marcos. "Let's get him on the stretcher," he snaps, slamming the epi into Ralph's IV line. "We're losing him in this rain."

Officer Daniel Martin helps Marcos heave Ralph onto the stretcher, his body slack and dripping. Regina scrambles after them, her shoes skidding on wet pavement.

"You have to save him!" she shrieks, grabbing Frank's sleeve. He peels her fingers off without looking. "Ma'am, stay back!" He vaults into the ambulance after Marcos.

Inside, the AED whirs, the third shock incoming. Ralph's body jolts again, but this time, the monitor spikes erratically.

"Sinus rhythm!" Marcos barks, slapping a non-rebreather mask over Ralph's face. Frank grabs the radio. "Medic 12 to OHSU, we've got ROSC on a STEMI, ETA eight minutes. Prepare cath lab."

The ambulance lurches forward, sirens wailing. Frank keeps one hand braced against the stretcher rail, the other adjusting Ralph's oxygen flow. The man's eyelids flutter in half-consciousness, his breath ragged but present.

"You're fortunate," Marcos mutters, wiping sweat from his brow. "Most STEMIs don't get ROSC in the field." Regina clutches Ralph's limp hand, her mascara bleeding black streaks down her cheeks. "Is he... is he gonna make it?"

Frank doesn't answer immediately, watching the EKG dance erratically. "Depends how much heart muscle died before we got to him," he says, quieter than he intended. The ambulance takes a sharp turn, throwing Regina against the wall.

"Easy!" Frank snaps at Marcos through the partition before turning back to Ralph. The man's lips are tinged blue beneath the mask. Frank checks the IV drip, nitro running, and adjusts the flow.

Regina wipes her face with trembling hands. "They'll fix him at the hospital, right? They have to." Marcos shakes his head, refocusing on threading through traffic.

Frank watches Ralph's pulse stutter on the monitor. "His LAD's probably blocked," he murmurs. "They'll stent it if we get him there in time."

The ambulance swerves onto the Ross Island Bridge, its metal grates rattling beneath them. Regina grips the stretcher rail, her knuckles bone-white. "He can't die," she whispers, more to herself than anyone. "Not like this."

Frank's fingers tighten around Ralph's wrist, feeling the thready pulse skip like a bad transmission. The monitor beeps erratically... ST elevation creeping higher. Marcos curses from the driver's seat as a semi cuts them off. "Out of the way!" he snarls, laying on the horn.

Regina clutches her husband's hand like a lifeline, pressing her forehead against his knuckles. "You promised we'd see the tulips in Woodburn," she whispers. Ralph's eyelids flutter, whether in response or a dying reflex, Frank can't tell. The oxygen mask fogs weakly.

Marcos swerves hard onto Naito Parkway, nearly clipping a motorcyclist. "Two minutes!" he shouts over his shoulder. Frank braces himself against the stretcher as Ralph's pulse stutters again.

The EKG squiggles into something ominous: VTach now, not sinus. Frank mutters something then reaches for the paddles. "Regina, back up!"

The ambulance jerks to a halt outside OHSU's ER bay as Frank delivers the fourth shock. Ralph spasms violently, then the monitor spikes back into rhythm just as the doors burst open. A trauma team swarms the stretcher, shouting for meds and vitals.

"LAD occlusion, ROSC en route, third-degree AV block!" Frank barks to the cardiologist, wiping sweat from his brow. A nurse pries Regina's grip off the stretcher as they wheel Ralph toward the cath lab, his oxygen mask fogging unevenly.

Regina stumbles after them until her knees buckle. Marcos catches her before she hits the linoleum. "They'll do everything they can," he says, though his voice lacks conviction. She claws at his uniform. "What if he..."

Frank strips off his blood-smeared gloves, watching the trauma team disappear around the corner. The adrenaline fades, leaving exhaustion in its wake. His fingers tremble slightly, whether from fatigue or the coffee he chugged three hours ago, he isn't sure.

THE END