Page 23 of Maybe
Lola was the baby's name. We only learned it afterwards. She had two doting older sisters, Molly and Sophie. I suppose we might have known it at the time, but Alaric was too busy jabbing an intraosseous needle into the flattened face of Lola’s tiny tibia to process names and stories. Myself, I was too busy calculating the adrenaline dose for a 6.2 kilo infant while simultaneous checking the settings of the defib—no mean feat when your own insides had turned to frost and your legs to jelly. Add in Lola’s mum, screamingno, no, no,over and over like it was the only word she knew, and recalling our own names would have been an achievement. The rest of her vocabulary must have vanished at the same time as her world was wiped from beneath her. That anguishedno, no, nowasgoing to haunt us for weeks. Lives didn’t need to be long-lived to be impactful— nonsensical cot deaths were proof of that.
After it was over, we took a breather for twenty minutes, enough time for a piss and a coffee and to complete the paperwork. Not a minute longer, as the waiting room still needed clearing of the walking wounded. Our hourly patient throughput rates were audited and displayed on a big wallchart in the main entrance and management had already given the department a bollocking this month for breaching wait times targets. Alaric said we should give management a call, send them a pic of him with a fag hanging out of his mouth and surrounded by the aftermath in the resus room; the plastic wrappings and syringes, the shredded baby clothing. Debris from a short brave battle, sadly lost.
“I should have fucking said no to the extra shift. I’m not cut out for this, Isaac.” Alaric shoved his head through the coffeeroom window again, sucking on his second nicotine fix in three minutes. I’d be tempted to join him if I thought it would do any good. “ThisED shit.That,” he waved his arm back in the vague direction of the resus bay, “ED shit…”
“Yeah you are,” I disagreed, like I always did. “You were great.”
He huffed. “I don’t know how you do it. Unless you’ve got a secret stash of ketamine that you’re not sharing with me? Which would be fucking rude, frankly.” He coughed and spat. “I’ve scrubbed in theatre loads of times for burst aneurysms and watched an adult’s life bleed away. I’ve assisted at open and shut bowel cancer surgery, all the while knowing the patient isn’t going to make it until Christmas. And I’ve sprinted to fuck knows how many cardiac arrests. But I never feel like this.” He blew out a long breath. “There’s something about… I dunno… the families… the kid’s sister, still wearing her pink fluffy jimjams. Like an ordinary, safe home life is being dragged into the hospital. It gets to me, Isaac.”
“I know.” I drained my plastic cup, wondering whether I had time for another. Our Friday night punters could keep their coke and heroin fixes. I didn’t care what anyone said; caffeine was the world’s most powerful drug. Already, I felt more my normal self. A tinny radio balanced on the sink played cheesy pop hits. I didn’t recall it ever being switched off.
This wasn’t our first conversation along these lines; it wouldn’t be our last either. You didn’t truly know someone until you discovered what made them sob or laugh hysterically at 4 a.m. For me, it was comforting an old man watching his wife’s life drain away while telling me they’d been married for sixty years, and he didn’t know how to live without her. For Alaric, it was a tiny pair of pink fucking pyjamas.
Still, he’d be okay about it in a couple of days; he always was. His coping recipe consisted of spilling to his wide circleof friends, then drinking, dancing, and fucking, in no particular order. Whereas mine was… undefined.
“How did you manage to explain to the parents halfway through that we weren’t winning, without bursting into tears?” he lobbed back into the room from over his shoulder. “‘Cos that’s what I’d have done. How come it doesn’t bother you as much?”
“It does. I just… I don’t know.” I wouldn’t analyse it now—I never did. When everything went tits up, I located that numb spot, that still, quiet vacuum in the eye of the storm. No way could I try to explain that to Alaric. For someone who hated it, he put on a great front of being cool, calm, and collected himself, at least until we retreated to the coffee room.
“I mean,” he carried on, waving his cigarette around, “look at Luke. Last I saw of him, he was a bloody quivering wreck. And you know everyone says he’s got alopecia? He hasn’t. He’s pulled the whole lot out. I saw him do it—huge fucking clumps of it. And I understand why, I understand why he’s tried to top himself. You can only soak up so much of this fucking stuff before it comes back out again. Half the nursing staff ran out of there in floods of tears, I’m mainlining nicotine and trying not to puke, and you’re quietly sipping your coffee like you’ve strolled away from examining a fucking sprained ankle. I’m worried about you, Isaac.”
“I’m fine,” I insisted. Up and not crying? I counted that as a win. “Honestly.”
“Well, all I’m saying, if you’re not fine, then you bloody hide it brilliantly. Earlier, when that old woman came in with chest pain and then arrested, you were amazing with her husband. I’ve never known a guy more suited to stuff like that. Your peopling skills are off the scale. Fuck knows why you’re even doing the surgery exams with me.”
“You know why.”
“He’s dead, Isaac.”
Oh God.Et tu, Brutus?“What’s that got to do with it? I love surgery. Surgeons talk to patients too, you know. Plenty of cardiac patients are old and have complex health needs.”
“Yeah, but you won’t have time for all the touchy-feely stuff and the general medical side of things. The geriatricians and intensivists coordinate that while you’re balls deep over an open chest in theatre.”
“Yes, I will. I’ll still have clinics and ward rounds.”
The blue flash of an ambulance lit up the dull coffee room, littered with empty cans, crisp packets, and random items of clothing. It reminded me of the end of a really shit school disco when they turned the lights back on. “I know how much this gets to you, Alaric. You’re only here tonight for the extra cash. Perhaps you should start saying no. Or do a straightforward surgical locum at one of the private hospitals, if you need the money. Stay in your pristine operating theatre, fiddling around inside people’s bodies to your heart’s content.”
“Are you telling me or yourself, Isaac? Who are you trying to convince? You don’t even need cash. I think you’re here because you actually really like it. It calls to you.”
Well, what did it matter? I was destined to be a cardiac surgeon. Thanks to my dad, my surname was even already written above the door to the cardiac cath lab! Checking the clock, I got to my feet, and stretched. “Come on. There’s a nice woman in minors waiting to have her eyebrow stitched. Go and do it beautifully.”
The cot death triggered a formal debrief a day or so later— hospital management’s nod to caring for staff-wellbeing after a traumatic incident. ‘Formal debrief’ made the department sound like a well-oiled machine, like we were in the military or something. In reality, we crammed into the windowless sluiceroom while stuffing sandwiches into our mouths during a mid-week lunchbreak. There wasn’t even space for a fucking chair. Most of us stood, one heavily pregnant nurse perched on the lid of a plastic sharps bin. If they really cared for our well-being, we’d be offered the time and space for one-to-one counselling. Regardless, I led it—a role assigned to me by the boss for the first time. And though I felt a little out of my depth, various members of the team fed back that they’d appreciated my efforts and that, as a team, we’d done a good job. The debrief box was ticked: ten minutes later, the department drew a line under it and moved on.
CHAPTER 10
ISAAC
Ezra’s text randomly appeared during a busy afternoon of wading through an overfull waiting room. A recent bullshit piece in theDaily Mail,written by a doc who hadn’t set foot on the wards since Florence Nightingale did her rounds,brought a flood of patients to ED convinced their excessive flatus was diagnostic of cancer and requiring further investigation.
Nonetheless, as a result of Ezra’s unexpected communication, my phone now boasted a new screensaver. My cute nephew, taken at his school sports day, judging from the certificates he held aloft. Squinting at them, I deduced Jonty’s future either lay in running fifty metres with his leg tied to someone else’s or tossing a wellington boot.
That the boy belonged to Ezra was never in doubt, and not only from the way Ezra could hardly drag his eyes from him, paternal pride leaking from his every pore. But physically too, from Jonty’s stormy dark eyes, spelling mischief, right down to the direction of the curl of his too-long hair around his narrow shoulders, and even the way he leaned into his friend to say something, then tossed his hair back on a laugh. He was quitesmall for his age, if my quick medical rule of thumb served me right. Not that he was short exactly, but if Ezra purchased school uniform based on age, not size, then the trouser hems would trail along the floor and the sleeves dangle way beyond his skinny wrists.
The swingshad not been shorthand forplayground. Two rusted swing sets, a short metal slide only a toddler would briefly find amusing, and a broken roundabout, barricaded off. A sign at the entrance to the small park warnedno dogs, but enough evidence littered the stubbly grass suggesting no one had explained as much to the dogs.
No words accompanied the cheery photo. I wondered why Ezra had selected that one and why he’d sent it without any explanation. And why the picture of Jonty, grinning through so many gaps in his teeth, as though his tongue had been imprisoned, filled me with such joy. The kid looked delighted, like kids should, finding simple pleasures in rusty swings and welly wanging. And despite mine and Ezra’s childhood home in a leafy suburb of London so different it might as well have been on another planet, I’d challenge either of us to produce a photo of either of us appearing so happy.
“Aah, that’s adorable,” cooed Alaric over my shoulder. He tapped on the computer next to me, reviewing the blood results of a patient with kidney stones. I was supposed to be referring a child to the paeds surgeons with suspected appendicitis. “Going to keep the orthodontists in work in a few years’ time, though.”
