James was on his last ambulance run of the night. Technically, his shift ended an hour ago, but the bell rang within the last five minutes of his shift, and his replacement hadn’t shown up yet. 12-hour shifts were grueling, and he had begun to feel a twinge of resentment towards Sarah, as this was the third time that month he had been forced to work after his shift ended because she was late.



This call was about a potential heart attack. When he and his partner arrived, the man was responsive, but his wife had claimed he had been complaining of sharp chest pain. Usually, he would have just taken him to the smaller local hospital to be monitored. But with his irregular pulse and complaints of dizziness, they decided to take him to a hospital with a cath lab just to be safe. You can’t take chest pain lightly.



Just as he pulled up to the hospital, the man’s eyes rolled into the back of his head, and his short breaths became silent. The ECC monitor began to alert as the line evened out and then darted up and down chaotically, indicating V-Fib. The loose sweatshirt he had pulled down to put on the sticky pads for the ECC was cut open with shears, and his partner parked the ambulance, then rushed into the back to help me set up the AED.



The doors to the back of the ambulance flew open, and ER nurses helped them move the man into a room, immediately starting CPR. After 26 minutes, he was pronounced dead.

James went straight to work cleaning and reorganizing the back of the ambulance so he could go home as soon as he got back. On the floor in the ambulance’s corner, he noticed an odd-looking device. It was a small hourglass like the ones you get in the box of tabletop games, but it was made of heavy metal, and the sand inside was black. He figured it had probably fallen from someone’s pocket.



Maybe, he figured, one of the nurses was a DnD nerd who used it as a timer for medication administration or something. All the sand was on one side of the hourglass, but no matter how hard he shook it or what angle he tilted it at, the sand wouldn’t flow to the other side. With a shrug, he slipped it into his pocket and looked out the back window, hoping he would be one of the cars out on the road very soon.



Back at the station, now two hours over his scheduled time, Sarah was happily whistling while scrolling on her social media, a cup of midnight coffee in her other hand. She glanced up at him with a beaming smile as his partner clocked out and slipped out the back door.

“You were out pretty late. Huh?” she asked.



James nodded, “And you were pretty late, yourself.”



He could see her smile fade a bit as she returned to her phone. He knew she was struggling as a new paramedic, and was honestly surprised she stayed on after throwing up at one of the scenes a few weeks back.



“Here,” he pulled the hourglass out of his pocket with a smirk, “Maybe this can help you keep the time.”



“You’re too kind,” she said, rolling her eyes. She picked up the mini hourglass and flipped it. The black sand began to seep through to the other side.



“Huh. Weird, I couldn’t get it to work earlier…”



The chief stepped in, his face all red with stress, “Sorry to break up the gift giving, James. Glad you are back. I hate to do this to you, but Mike called out with COVID, so I’ll need you to extend from 12 hrs to 24 hrs. But I’ll make sure to give you a full 24 hrs off before your next shift.”



“You’ve got to be shitting me,” he grumbled, plopping down on one of the leather couches in the den.



Just as he did, the alarm went off again. This time, it was for a car crash.



“Ugh! Can’t people stop trying to die for like 10 minutes?!” He jumped up from the couch, grabbed his medic bag, and hopped in the driver’s seat of the ambulance. Sarah climbed in next to him on the passenger side. She was silent, looking down in her lap at the little hourglass, watching the sand fall.



“James?”



“Hmm?”



“Did that lady die because I couldn’t stomach going into that room to help her?”



James sighed. “No, Sarah. You can’t think like that. This job…this job is tough. You know? She was probably going to die anyway with those injuries. We can’t always be superheroes. Sometimes, it’s out of our control.” He tapped on the hourglass, “And sometimes, the time is just up. All we can do is say that we did our best.”

She nodded. The sand emptied all the way to the other side, and she flipped it again, but it got stuck again. He returned his gaze to the road, navigating some busier intersections as best he could.



“The sand got stuck on me, too.”



“I guess time’s up,” Sarah chuckled, smiling at him gratefully.



Suddenly, there were blinding lights, the blaring of a semi truck horn, and everything went black.



James woke up in a bright white room to the sound of beeping monitors and a pounding in his head. His body felt bruised and broken, and Sarah was nowhere to be seen. He looked at the table beside his bed to see a medical chart with his name on it beside the hourglass. The black sand was flowing, but it had almost run out.