At this particular moment on this particular Saturday morning, the Most Dangerous Driver crown had passed from the owner of the former white Thunderbird and now rested upon the unstable head of someone notable among all the remaining competitors in one interesting way: her blood alcohol level was zero. This is rare but perfectly acceptable. The Most Dangerous Driver in Portland had met the impairment objective not by blood doping but by the unusual yet effective means of having gone without sleep for two days, and even more importantly, by having been awakened a dozen times during that period when she was just at the verge of deep sleep.

There is a particular flavor to the kind of impairment produced when REM sleep is continuously interrupted and deep sleep denied. Brain cells fire in the wrong order, muscles and nerves stop speaking to each other, the skin feels like wax with sand embedded in it, and the victim is given over to stumbling, depression, bad judgment and the feeling that one’s entire past is a great burden which perches on the shoulder and digs its claws into the neck for support. The very air itself seems to clot and settle over the skin like a coarse, dry powder; one is always vaguely trying to sweep it away, get it out of the eyes, keep it from thickening and fouling the tongue.

The Most Dangerous Driver in the city of Portland was not merely impaired. She was clinically and possibly legally insane.

She was scoring particularly well in Category Two by simply no longer caring. This was not a failure to care in the usual moral or ethical sense but in the deeper sense of just what it was that the brain was not up to at that moment, that being that it was not up to either perceiving, or generating thoughts about, the connection of cause to consequence. A flock of nuns carrying orphans in their arms might have stepped out in front of her and the Most Dangerous Driver in the city of Portland would have run over as few of them as possible, certainly, but she would not have slowed down.

In fact, for all she cared (or failed to care) God could have finally tired of her and all her ilk, could have just grown divinely bored or righteously angry or simply become arbitrary, as it is God’s perfect right to be, and opened up the road ahead, just unzipping the asphalt in front of her right along the dotted white line, and cast the whole shebang – her, her passengers, the nuns and the truck itself – into The Pit, and the only thing she would have cared to ask during the long descent was whether they supplied pillows at the bottom.

The Most Dangerous Driver in Portland was driving straight down the median strip on SE 39th Ave just because the law said she could, beacon rays flashing, working the headlight from normal to brights and back again with her foot, and switching to a different electronic siren pattern for each block. On the short block between Burnside and Couch it was the traditional wailing siren, then between Couch and Davis the honking screech siren. At Everett she was distracted by a shirtless early morning runner so that the European style accordion siren – her favorite anyway – stayed on past Everett and Flanders down to Glisan. Seated on a medical kit just between the two captain’s seats, the medical student observer, Jeff Kyurol asked, “This can’t be normal. This can’t be the way you’re supposed to drive.”

The Most Dangerous Driver in Portland, the clinically insane Cathy Remy, glanced at him in the rear view mirror. “Nothing’s normal. Get that nonsense out of your head.” She pointed with her right arm toward Mt. Hood, still silhouetted against the morning sun. “Look at that mountain. Have you ever stopped to notice the pattern of the peaks? Big peak on the left, then sharp valley then smaller peak on the right. Remind you of anything?”

“Dear God.”

“That, almost-Doctor, is a classic EKG right bundle branch block pattern, is it not? So I ask you, just how so-called normal is it for a dormant volcano to look like an abnormal EKG ? Just what’s your answer to that?”

“Cathy, you are not alright at this moment.”

“Physician, heal thyself. You are sleep deprived and a complete mess.”

“Yeah, but I’m not trying to drive a two-ton truck on an emergency call.”

“And thank God for that! You’d be a menace behind the wheel in your condition.”

In the passenger seat, Happy Hal Evans complained, “Bedside Manor. I freaking hate going on calls at Bedside Manor.”

Cathy relinquished the most-dangerous-driver title less than a mile after she had gained it – sic transit gloria viae – when a PPD patrol car blew the intersection at Burnside traveling only marginally faster than the speed of sound, just a blur of white and flashing blue that missed becoming the dominant feature in Cathy’s driver’s side door by a few tenths of a second and leading her to muse for the remainder of the drive to Bedside Manor upon whether the cop car would have neatly transected her body at that speed or just pulped it up like one of those poor raccoons that wanders onto Barbur Blvd at the wrong time of day and gets run over not just by a single car but by the entire morning rush hour.

The inert form of Elmo P. Gersten lay in the parking lot of the Bedside Manor in front of a big white station wagon. His hat and cane lay neatly beside him just as if he had placed them there himself before lying down alongside them. The driver of the station wagon was standing next to the open door, shouting “Oh God!” over and over.

His shouting had interested the early starters in the tavern across the street. They were now gathered around the small body performing CPR before an audience of commuters and passers by. One of them was periodically pounding the old man on the chest with his fist, raising it up above his head and smashing it down in approximately the same location each time. He was yelling “Live, dammit! Live!” with each blow. The other young man was cradling the bald head in his arms so that the chin was tucked down into the sternal notch, and was blowing air into the mouth. He was yelling “Breathe, come on now, breathe!” after each exhalation. Together the two rescuers produced a nearly Caribbean rhythm: “Live, dammit live, pause, breathe come on now, breathe, pause, live dammit live, pause, breathe come on now breath, pause…”

“Thank God you guys know CPR” said one of the bystanders. The man from the tavern who wanted Elmo P. Gersten to live! was now sobbing while he pounded. He had removed his own jacket and placed it over the chest of the old man in order to prevent whatever complications of death are produced by taking chill.

A bus stopped at the curb and disgorged a half dozen early morning commuters. One of them was a middle aged woman in white polyester slacks and a blue polyester sweater. She took a look at the scene and raced up to the knot of onlookers. “What are you doing!” she yelled at the two men performing CPR.

“Live, dammit, live!” sobbed the pounding man.

“He won’t breathe!” shouted the other man who was blowing air into Elmo P. Gersten’s mouth. He was cradling the head on his lap, which bent it so far forward that the airway was sealed shut and the old man’s lips just ballooned out each time the man blew in and made a sound like breaking wind.

“It’s alright! I’m a nurse!” shouted the woman in the white slacks.

“Thank God!” cried the man in between flatulent breaths.

“Breathe! Come on now, breathe!”

“Someone go and get a blanket!” the nurse ordered with great authority. “He’s going to get hypothermic!”

“Live, dammit, live!” shouted the man on the chest.

“Where’s that blanket?” shouted the nurse.

“Pfffffft” said the other man into Elmo P. Gersten’s flaccid cheeks.

So it was standing room only at the Bedside Manor parking lot when Cathy drove in. Happy Hal had to use the PA system to part the sea of onlookers and allow the truck to inch its way toward the accident scene. They saw a big station wagon, a crowd of onlookers and next to the station wagon, a small figure being resuscitated by two men with a woman shouting at them.