Cath Staincliffe - Witness

Fiona was back in the car, still smarting, when the pain hit. A band crushing her chest, impossible to move or breathe properly. A huge weight. She could feel her lungs contracting, the terror of a vacuum developing. Like drowning. No air, no way of moving. Sweat bathed her skin, her tongue felt huge in her mouth, her mouth chalk dry. An overwhelming sense of danger, animal-keen, consumed her, urging her to flee, but she was pinned down by the pain. She was dying. Everything went dark, then red. There was a roaring in her ears and her hands and feet were nettled with pinpricks. Her knees were juddering, heels drumming in the footwell.

She gulped and found a breath, then another. The pain dimmed, her vision cleared. Trembling spread through her body. She felt sick. Her heart hurt, thudding irregularly in her chest. She couldn’t possibly drive. Her eyes filled with tears.

Opening her phone was awkward but she only needed to press one button for Shelley’s number.

‘Please can you come and get me,’ she told her when she answered. ‘Get a cab.’

‘What?’

‘I can’t drive, Shelley.’ She reeled off the address.

‘Why? What’s happened?’

‘I need to get to the hospital. I’m having a heart attack.’

The shaking wouldn’t stop, and the waves of nausea. Every time she closed her eyes, with each blink, she saw a still from Sunday: Danny prone, his leg twisted at an odd angle, blink , the fear in his tawny eyes, blink , the blood in the creases of her knuckles.

When Shelley arrived she was alive with concern. ‘Why on earth didn’t you call an ambulance?’

‘I don’t know.’ Because the ambulance was too much like Sunday? ‘It’s much better now. Perhaps it’s just angina.’

Of course A &E was busy. It always was. She spoke to the triage nurse, filled in the form and took a seat in the shabby waiting area, all lumpy green gloss paint and scuffed linoleum. There were two dozen people on the chairs.

‘No point in you waiting,’ she told Shelley.

‘I don’t know.’

‘I’m fine. Honestly. The pain’s all gone.’

Shelley took some persuading but they both knew enough about hospitals to realize it could be a long time before Fiona was seen. ‘Can you do me a favour, take my car home?’

‘Of course, and let me know what they say.’

She had nothing to do. Nothing to read. She passed the time examining her fellow casualties, trying to work out what accident had befallen them. Some were easy: the schoolboy in his PE kit with a makeshift sling and the elderly woman with a grazed knee complaining to all and sundry about the kerbs. But others had hidden traumas.

The time inched by. Patients were called through to the examination bays and others took their places. They would have brought Danny here. Through the other double doors straight into the resuscitation suite. And then to the mortuary.

‘Fiona Geary.’

She stood and followed the nurse to a bay. ‘You’ll know the drill,’ the woman joked. A reference to Fiona’s uniform. ‘You at St Mary’s?’ The maternity hospital was nearby.

‘Yes, on the community.’ Some of the midwives worked all their shifts in the hospital. The community midwives made the home visits before and after birth, carried out home deliveries, worked with women on the domino scheme, where they only went into hospital for the actual birth. Fiona preferred work in the community. There was more freedom and greater responsibility. Less intervention. The consultants held less sway.

The nurse handed Fiona the thermometer, which she tucked under her armpit. She tested her blood pressure. Both readings were a little high. ‘Any symptoms now?’

Fiona shook her head. ‘Just a bit tired, a bit dizzy.’

‘Any breathing trouble?’

‘No.’

The nurse checked through her form. No history of asthma, allergies, no pre-existing medical conditions. No regular prescriptions. Any family history of heart problems? Yes, her father. Fiona felt the prick of irritation. It was already all down there in black and white, she’d filled the form in today, did they think she’d developed diabetes or epilepsy in the meantime? She knew she was being unreasonable. She double-checked the same details with her own patients. She answered all the questions as reasonably as possible. The nurse left her for a few minutes and then a doctor appeared. The doctor looked at the form and listened to her heartbeat. Then she was sent back to reception to wait.

Another half-hour passed. Fiona knew that a lot could be done with heart disease. She was a little overweight but nothing excessive. They might put her on statins to lower her cholesterol, or do a bypass. A nurse brought Fiona a form and asked her to take it to Cardiology. The hospital was a maze: annexes and prefabs had been bolted on to the old Victorian buildings, sprawling in all directions and now connected up to a spanking new extension. Complicated colour-coded signs were there for navigation.

She handed the form in to the receptionist at Cardiology and took a seat. There was a water cooler there and she was thankful to drink a cup, to clear the stale taste from her mouth.

The ECG took ten minutes. The cardio guy attached the stickers to her arms, legs and chest, and she lay down on the curtained bed while the machine took its measurements.

There was nothing wrong, no arrhythmia or palpitations, no indication of any heart trauma. No echo of myocardial infarction. The cardiologist, giving her the results, asked her to describe again the symptoms she’d had. As she did, she felt her mouth get dry and her pulse speed up, a sense of dread creeping up her spine.

‘The tingling,’ he asked, ‘where was that?’

‘My feet and my hands.’

‘Any cramping in the arms?’

‘No.’

He nodded, pleased with her answers. ‘I think the good news is that there’s no sign of a heart attack. But there is an explanation that accounts for all the symptoms you describe, and that’s a panic attack.’

Fiona stared at him.

‘Have you been under any particular stress recently?’

‘Yes,’ she whispered. Felt her tongue stick to the roof of her mouth.

Another nod. ‘Your GP will be able to help,’ he carried on, ‘discuss the treatment, ways of managing it. It may be a one-off. Some people have an attack once and that’s it.’

But the rest? She was appalled. It could happen again.

She went to the walk-in clinic at her GP’s practice the following morning. Dr Melling wasn’t her regular doctor but she couldn’t wait for an appointment, she had to see someone straight away. When Fiona tried to explain what had happened, starting with Sunday, the words clotted in her mouth and she was alarmed by tears in her eyes.

‘Take your time,’ the GP said.

‘The boy that was shot on Sunday,’ Fiona said.

Sympathy rippled across the doctor’s face. It made Fiona feel worse. She gave the gist of the story. ‘Then when I went back I had this, erm, this panic attack.’ She felt small and frail as she spoke. ‘The doctor at the hospital said sometimes it just happens once. But it was so awful…’

‘Have you heard from Victim Support?’

Fiona nodded, a letter had come yesterday.

‘They can help. Or we have a counsellor here, if you’d like someone to talk to. Just let me…’ She turned and hit some keys on her computer. Read up a bit. ‘Cognitive behaviour therapy can be very useful, that’s what Hazel’s trained in, good success rate reported. The other usual treatment is antidepressants. Some patients find a dual approach most useful.’

Fiona listened to her talk about side effects and the need for gradual withdrawal. ‘It may be that you’d prefer to wait and see if there is any recurrence.’