Caroline Anderson - The Spice of Life

‘Just being realistic, old thing.’

‘Well, don’t bother—and don’t call me old thing. Just do your job, please. Have you stopped that bleeding yet?’

He shook his head. ‘It’s leaking from the abdomen—I think he needs a bit of surgical attention.’

Kath shot him a dry look. ‘You guys are really sharp today, aren’t you?’

Jack was inspecting the young man’s chest dispassionately, watching the ragged rise and fall of the ribs as he dragged in a breath between screams, and he shook his head thoughtfully. While he ran thorough hands and eyes over his shattered body, Kathleen started cleaning up the chest area ready for the heart monitor after checking the IV line that was running in Haemacel and taking blood for cross-matching, dodging round the radiographer who had brought the portable in and was taking X-rays.

When his chest was clear, she put on the pads for the heart monitor, frowning slightly as she did so at the feel of the chest wall under her hands. As she watched his breath jerked in, and a large section of his chest wall moved in instead of out.

‘Flail chest,’ she said quietly, and Jack nodded, drawing her to one side.

The lung’s collapsed, I think. Probably where he was hit by the train. His pelvis is shot to hell, too, and judging by the feel of the abdomen, he’s got massive haemorrhaging.’

Kath nodded. ‘So why is he still alive?’

‘God knows.’ Their eyes met and tracked together to the heart monitor. ‘He’s not doing too well, is he? I think we need an echocardiograph. Can you get the cardiographer?’

Not that there’s a great deal of point, Kathleen thought to herself, but we may as well go through the motions.

While she phoned the switchboard and requested that they page the cardiographer, Michael Barrington the orthopaedic SR arrived and glanced at the shattered stubs of the young man’s femurs.

He swore, softly and succinctly. ‘Got any X-rays yet?’

Jack nodded. ‘Yes, they’re just being developed.’

Michael pursed his lips. ‘Done a real job on himself, hasn’t he? Anyone know why?’

‘No. We don’t even know if it was an accident yet.’

Their eyes flicked to the monitor. Their patient was still alive but his condition was deteriorating visibly. The anaesthetist, Peter Graham, had arrived and managed to dull his pain. Now he merely lay and moaned, but at least he was no longer screaming.

Amy popped her head round the door to tell Kathleen that they had found some ID on the track and the police had brought his parents in.

‘His name’s Steven Blowers. They want to see him.’

Kathleen exchanged glances with Jack, and he shook his head.

‘Put them in the interview-room and give them a cup of tea. One of us will be out in a minute,’ she told the young nurse. ‘Oh, and Amy? Say nothing.’

Amy nodded gratefully and retreated.

The X-rays appeared and Michael ran a critical eye over them.

‘Ouch. Do you want me to interpret, or is it academic?’ he said quietly.

Jack’s mouth lifted in a wry smile. ‘Probably. We’ll see what the cardiothoracic guy has to say.’

When he arrived moments later, he took one look at the X-rays and shook his head.

‘You jest, of course?’ he said drily. ‘Look at this shadow here—probably a bulge in the heart or the aorta behind it—the kid’s a goner. He’ll never make the anaesthetic, and even if he did, who wants to be a bloody cripple? Oh, well, we can only fail. Let’s have him up in Theatre.’

He sauntered out, whistling, and Kathleen met Michael Barrington’s eyes. They were like chips of blue ice, his lips compressed into a thin line.

‘Call me if you need me in Theatre—but I’d just as soon Tim Mayhew did it—I don’t trust myself near that bastard.’

And he turned on his heel and stalked away, his limp almost imperceptible.

Jack raised an eyebrow. ‘What’s eating him?’

‘He’s a bloody cripple,’ she said succinctly.

‘What?’

‘He has an artificial leg. He went to assist at a passenger train derailment last year and got trapped in the wreckage. We had to amputate part of his leg to free him.’

‘Ah …’

Just then their patient moaned and opened his eyes. Kathleen was there instantly.

‘Steven? It’s all right, you’re in hospital. Can you hear me?’

He licked his lips and nodded slightly. ‘Messed it up, didn’t I?’ His voice was a mere thread. ‘I thought it would be quick,’ he went on painfully. ‘Let me go—please, let me go. You don’t know what this is all about.’

She squeezed his hand. ‘Do you want to tell me?’

‘Danny,’ he whispered. ‘My fault … gave Danny—HIV.’

‘Oh, Christ,’ someone muttered behind her. Kathleen closed her eyes. The room was a bloodbath, all of them were covered, and their patient was HIV positive.

Great. Oh, well, it had happened before, doubtless it would happen again. As far as she was aware, no one had cut themselves or pricked themselves with a needle.

Behind her she could hear Jack calmly telling everyone to go and shower and change and come back in full barrier gear.

She could see blood on Jack’s cheek and on his arm above the gloves. God knows where it was on her.

Steve groaned again, and the nurse in her took over.

‘YOUR parents are here, Steven. They’re waiting to see you. Do you feel up to it?’

His mouth twisted in a bitter little smile. ‘You mean I’m going to feel better?’ he whispered.

It wasn’t really a question. Kathleen lifted her head and met Jack’s eyes pleadingly. He nodded.

It was time to be honest.

‘You’ve got severe chest and abdominal injuries, as well as the injuries to your legs.’

‘Will I die?’

She was struck by how blue his eyes were as they bored into her own—blue and clear, like the sky. What a bloody waste.

‘I’m afraid it’s quite likely.’

‘Don’t be—afraid. It’s OK, really. It’s what I want …’

His eyes flickered closed, and he licked his lips. ‘Love a drink.’

‘I’ll get you some iced water.’

She found a nurse and sent her for it, and then held the cup and dabbed his lips with a swab dipped in the water.

‘Thanks.’ His voice was weaker. Kathleen didn’t think they could afford to wait any longer.

She met Jack’s eyes, and he nodded. ‘I’ll get them.’

‘Thanks.’

As he moved past her, she took a clean swab and wiped his cheek.

‘You could change your coat first.’

He glanced down and gave a short, humourless grunt of laughter. ‘Yes, I think you’re right. Put a blanket over him.’

He was only gone a minute, and when he returned, it was with a couple in their fifties who were holding hands as if they were desperately hanging on to reality.

They were obviously shocked by his condition and lost for words, but he shocked them further with his.

‘Never been what you wanted—I’m sorry. Never meant to hurt you,’ he whispered.

Kathleen swallowed a lump in her throat, Ben coughed discreetly and Jack busied himself at the X-ray box.

The phone on the wall rang softly, and Kathleen answered it.

Theatre’s ready for him,’ she said quietly.

Jack nodded and took a step towards Steve where he lay surrounded by his family, and then everything seemed to happen at once.

The monitor shrilled, Steve moaned, his mother gasped, and everybody leapt into action.

‘Pressure’s dropped right away,’ Kath said quietly.

‘Damn, he’s arrested,’ Jack muttered, and flung the covers off his chest.

Kath snatched up an airway and tipped back his head. ‘Ben, come and bag him while I get the drugs.’

She handed the airbag to the registrar while Jack pressed rhythmically on the patient’s sternum. ‘What do you want, IV adrenalin, calcium and atropine?’