The Spice of Life

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?’

Jack nodded. ‘And adrenalin into the heart. Let’s not mess about.’

Someone suggested to his parents that they should leave, but no one had time to show them out.

She handed Jack the syringe with the long needle, and he slid it neatly between the ribs and into the heart while Kath injected the other drugs into the giving set in his arm.

‘OK, let’s check the monitor.’

They glared at the screen, willing the line to flutter into life, but the trace remained persistently flat.

‘Come on, damn it!’ Jack muttered and thumped his chest again. ‘Now!’

Nothing.

‘Try again?’ Kath said quietly.

Jack let his breath out on a sigh and shook his head. ‘His aorta’s gone. It’s pointless. Damn, damn, damn …’

He removed his hands, stripped off his gloves and stepped back, only then noticing the stricken parents still standing near the door. He lifted his hands helplessly.

‘I’m sorry—we did everything we could.’

‘Oh, thank God it’s over,’ his mother said unsteadily, and then the tears overflowed and ran down her pale cheeks.

Kathleen carefully covered the shattered body with the blanket, but left his face uncovered. Relatives hated to see a sheet over the faces of their loved ones. It was illogical, but quite understandable, and she respected that. Sticking her head out of the door, she summoned a nurse and got her to take the young man’s parents back to the interview-room and give them a cup of tea.

They cleaned themselves up quickly, instructed all the others to shower again as thoroughly as possible in view of the AIDS risk, and then went into the interview room to talk to Steve’s parents.

Jack was astonishing. All day long she had wondered how he had managed to bamboozle his way into a consultancy, but first the calm, unflappable way he had dealt with Steve and now here, with the devastated relatives, Kathleen had an opportunity to see at first hand the qualities that set him apart as a consultant.

He talked through the whole drama again with them, explaining the various problems their son had had, discussing the probable outcome of each of his injuries had he survived, and then, when there was no doubt left in their minds that he should have died, he gave them even more.

‘Whatever problems you’ve had in the past, remember that he loved you, and you loved him. No one can ever take that from you.’

It was a calculated tear-jerker, but delivered with great sincerity, and Kathleen found her own eyes misting over.

She escaped to her office as soon as the Blowers’ left, grabbing herself a cup of coffee on the way. Seconds later there was a tap on her door and Jack came in.

‘Are you OK? You looked a bit shaken up.’

‘Oh, yes, I’m fine. It all adds variety. You know what they say—the spice of life, and all that …’

Her voice cracked and she cleared her throat.

He gave a grim little smile. ‘If you say so, Irish. Got any of that coffee left?’

She handed him the cup and he swallowed the remains with a gulp.

‘Home, I think. Fancy a drink on the way?’

She remembered their inauspicious start, and her somewhat ungracious behaviour during the morning. Perhaps it would be an opportunity to smooth things over, to apologise again and make a fresh start.

Her mouth was opening, the reply ready, when there was a tap on the door.

‘Ah, Mr Lawrence—there’s a young man who’d like to talk to you. His name’s Danny Featherstone. I think he’s a friend of Steven Blowers.’

He nodded at the receptionist. ‘Put him in my office. I’ll be along in a tick.’

He turned back to Kathleen and shrugged.

‘Sorry.’

She took a deep breath.

‘Maybe later?’

He shook his head slightly. ‘Some other time, perhaps. I don’t know if I’d be very good company tonight after all. I’ll see you.’

And with that, he was gone.

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