The first scan appears on the screen. There’s blood around your spleen – a wait-and-see injury. Then it’s your spine. I stare at it – notch by notch, inch by inch. You’re lucky there is no damage.
Just the head CT to go. The screen turns black then the shades of grey appear.
You’ve got an intracranial haemorrhage on the left side of your brain. I picture the bus again, ploughing into you. I picture your legs crumpling, body flying, head smacking the tarmac. It’s bad. As bad as it gets. You’ll die if we don’t act quickly.
A shot of adrenaline hits my body, shaking up my senses better than a hundred cups of coffee. You have been torturing my life for months, and now you need me to save yours.
But what if I don’t?
Chapter 11
Jenna
The thought is sharp – an electric shock.
You need to be sedated immediately and shipped to intensive care. The longer you are awake, the longer your brain is active and the more damage the bleed will do, until eventually your brain will be starved of oxygen and you’ll die.
I stare at the blob of bright white where only grey should be. It’s a textbook example of an intracranial haemorrhage. The kind of scan the lecturers put in the PowerPoint slides in year one of medical school. Unmissable. But what if I did miss it? What if I let you die?
The question is so alien it doesn’t feel like my own. As though someone else has whispered it so quietly into my ear that it slipped past my eardrum to the place where my own thoughts exist without me noticing.
It can’t be my thought, my question. My whole life is about being a doctor. Yes, I live to be in A&E and the unspoken excitement of the emergency, but reallyit’s about the people, it’s about helping. Whether it’s the plumber with the broken foot or the girl with the infected piercing, whether it’s blue lights flashing or the slow steps of someone who’s walking through the door themselves, I long to help, to treat, to save. It’s what makes me who I am, it’s the one thing you haven’t stripped from me, so I can’t let you die.
But if you live, if things carry on the way they were, how will I survive?
I close my eyes for a moment and try to remember what it felt like to walk down the street unafraid, or to check my emails without my heartbeat skyrocketing. The images don’t feel real and yet hope still pulls at my chest. I could stop hiding inside our house and take Beth and Archie to the beach and the funfair, to London to ride the open-top buses. We could be a family again.
My head jumps forward two steps from theoretical to practical. I could claim it was a mistake. Human error. It wouldn’t be the first time. In my first year of specializing in emergency medicine I missed a post-surgical pulmonary embolism in a young mother of three, and if it wasn’t for the quick work of the senior registrar on duty, she’d be dead.
With you, I wouldn’t even have to do anything. Your only hope is if I walk into resus right now and tell Thomas about the scans. If I don’t, by the time the radiologist calls down to speak to one of the team the damage will already have been done.
Time marches on. I don’t slide from the stool and walk away, but I don’t go to resus either.
‘Jenna,’ a voice calls from behind me.
I jump, and when I turn the room turns with me in a sickening wave of dizziness.
‘Your trauma patient’s SATs are dropping.’
I almost fall from the stool in my haste to get off, as if my feet don’t get the message it’s time to move. The resuscitation bay is busy again – Callum is back with Amie and Thomas, and they’re all waiting for my command.
‘It must be the pneumothorax,’ I say, scrubbing my hands at the sink and pulling on a pair of gloves. ‘Let’s sedate him.’
‘Matthew,’ I say, leaning as close as I can bear. ‘You’re having trouble breathing. I need to sedate you to fix the chest tube in your side.’
My hands move, steady and confident now. I find the problem – a kink in the tube inside your chest. I hold the tube in my fingers. My heart is pounding in my ears. I don’t breathe. How many more seconds can your heart hold out for before it gives up? Ten? Twenty?
Suddenly Diya is by my side. ‘Is everything all right?’ she asks. ‘Do you need a hand? Prep another chest tube,’ she says to Amie.
‘No. It’s OK. I’ve got it,’ I say, forcing my fingers to move, to fix the problem.
Your oxygen levels climb, your SATs normalize. I’ve saved your life.
Thomas steps forward, less self-assured now than ten minutes ago.
‘You did everything right,’ I tell him, and it’s true. ‘Sometimes this happens.’
He nods. ‘Thanks. The X-rays show a dislocated elbow, a broken femur and a jaw dislocation at the mandible.’
