Authors: Kate Eberlen
The ambulance men gave me the look of contempt that proper professionals reserve for student doctors. ‘We’ll take you to the triage nurse now, who’ll go through all the
details.’
I was called away to a dance student who’d had a fall and sprained or broken her ankle and after that it was my lunch break, so by the time I saw Mrs Collins again, she must have been
waiting for over an hour. ‘How’s the arm?’
‘It’s ever so white . . .’
‘Have you seen a doctor?’
‘Just waiting for one. It’s very busy, isn’t it?’
The only reason I could think of for someone having a cold, white arm was lack of blood supply. Which, in the absence of a tight sleeve or tourniquet, seemed to me to indicate a blocked artery.
And the only way I could think of for an artery to be blocked was a clot. And clots weren’t good.
I was wracking my brain to think of another explanation. Who was I to think I might know better than a triage nurse who’d been seeing patients for years? And yet, once the alarm had
started ringing in my head, it wouldn’t stop. I went to the desk and enquired what was happening with Mrs Collins, trying to imply that the old lady was badgering me. The desk nurse looked at
her screen and told me that Mrs Collins was on the list for the vascular registrar.
‘Has he been informed that it’s urgent?’
I got a look that said I was now reaching beyond my competence, which I already knew, but having taken the decision to brand myself a troublemaker, I had already done the damage and I
wasn’t prepared to back down.
At school, I was never very good at not-blinking contests, and I’d never, ever managed to beat Ross, but I was determined to get the nurse to pick up the handset of her phone. She punched
a number into the keypad, then handed the handset to me. ‘Probably best you explain.’ There was a whisper of triumph in her voice.
The vascular registrar was clearly not someone to be messed with.
‘Yes?’ Curt. Female.
‘Hello . . . Er . . . I’m a student doctor, and I may be wrong, but I think there’s someone down here you should see rather urgently . . .’
‘And that’s because . . . ?’
I was in the middle of describing Mrs Collins’s arm, when I realized I was talking to a dead line. A smirk glimmered on the desk nurse’s face.
I’d alerted the expert. It was all I could do. If it was a clot, I wasn’t qualified to prescribe a blood-thinning agent anyway. And if it wasn’t, and I did, there’d be a
risk of haemorrhage. I wasn’t even any good at getting an IV in. That had been proved pretty conclusively on several occasions when I’d had to call in a nurse to help me. Ultimately,
what you find yourself thinking is:
If she dies now, it won’t be my fault
.
There was nothing more I could do.
I dislike that phrase.
It sounds so worthy and sincere, a shorthand for:
We’ve tried everything, we’ve worked as hard as we could, we’ve really thought about the individual concerned
, but in
reality, that’s rarely true. Not that I’m saying doctors are lazy, or that they deliberately make mistakes, but when it’s busy, things are missed or delayed. Very often, survival
is just a matter of luck.
I made my way towards the ambulance entrance and stood in the diesel fumes fantasizing about taking off my white coat and walking away, a free man.
In the first year of studying Medicine, I had been determined not to let my parents down. In the second, Lucy had convinced me that everyone else had the same worries and insecurities as me. In
the third, as other university students graduated and started earning, I realized that very few people really like the job they’re doing. At least it was possible to earn good money as a
doctor. But I’d never quite managed to silence the voice in my head that screamed, whenever I was under pressure,
I don’t want to do this!
On my way back in, I almost bumped into a very slim woman in a white doctor’s coat, which, unlike most doctors, she was wearing buttoned up. Intriguingly, no other clothing was visible
apart from very sheer black tights, or stockings.
‘Angus?’
Nobody apart from my parents had called me that for years.
‘Charlotte!’
‘Dr Grant to you!’
Was it a joke, or an order? Probably a bit of both. ‘Dr Grant.’
I grinned.
She didn’t.
‘What are you doing here?’ I asked.
Clearly, she was working at the hospital, but I hadn’t seen her before or noticed her name on the board in A&E.
‘I’m the vascular registrar. I’ve just come in and some bloody student calls me down here. What about you?’
‘I’m the bloody student.’
She sighed impatiently.
‘OK then. Where?’
I took her to Mrs Collins’s bed, stepping away as she drew the curtain around. I’ve never quite understood why that’s the procedure, because it gives the patient a totally
false sense of privacy and makes neighbours even more inclined to listen in. I hovered, hoping to learn something from Charlotte’s cool, professional consultation.
‘. . . right, well, Mrs Collins, what we’ll do is get a nurse to put a line into your other arm to get some medication in, and we’ll see if we can’t get this arm better
very soon.’
The curtain swept back sooner than I anticipated and I felt as if I’d been caught in the act of eavesdropping.
From her voice, I’d never have known that Charlotte considered the situation anything other than routine but her fury was obvious as she stormed towards the nurses’ desk, telling
them in no uncertain terms to get an IV of heparin into Mrs Collins as quickly as they could.
‘Then I want her admitted to my ward, understood? Who the bloody hell was in charge of triaging this patient?’
The nurse on the desk cowered visibly. ‘She’s on her lunch break.’
‘That’s very fortunate for her!’
Again, Charlotte turned round quicker than I expected, making me feel as if I was stalking her.
‘Good call, Dr Macdonald.’ She gave me a little wink as she marched past.
The exotic scent of her perfume lingered for a couple of seconds after she’d disappeared down the corridor, giving fleeting relief from the usual sour odour of disinfectant that never
quite masks the persistent background of sepsis and shit that pervades a busy A&E department.
The end of the school day brought in several boys with assorted football injuries, but the slight lull that often occurs in the early evening before the place starts filling up with
alcohol-related conditions, didn’t happen that day because there was a pile-up in which seventeen people were injured, one fatally.
At five in the afternoon I was asked if I would stay on, and only just had time to call Lucy on the new mobile phones we’d bought when we realized we would be in separate places.
It’s strange to remember a time when mobile phones weren’t connected to the Internet, and were only carried for use in an emergency. I stood in the bit where the ambulances come in,
because you weren’t allowed to make calls in the hospital, as the sirens’ wails got closer and closer.
When I said I wasn’t squeamish, that was before I saw people with their faces burned off. Strangely, the horror didn’t make me want to walk out, because I knew I could be useful. The
adrenaline keeps you going. You just do what you’re supposed to do. You live in the present. I only got time for one breather between ambulances. Standing in the same spot where I’d
earlier dreamed of walking away, I found myself thinking,
I love this job!
That was the night I started smoking. You’d think doctors wouldn’t, with the health risks. But it doesn’t work like that. When you’re witnessing how tenuous life is, you
don’t seem to care as much about the vague notion of future health. I’d smoked at school. You had to if you didn’t want to get labelled a wuss. So when I was offered a cigarette
by the male nurse who was standing beside me, it felt like a gesture of solidarity to take it.
I didn’t get off until after eleven, having kept myself alert for sixteen hours. I wasn’t tired, but I would have gone straight back to the flat if I hadn’t
run into Charlotte at the hospital entrance.
‘Angus,’ she said. ‘Again!’
I couldn’t tell whether the repeat encounter was welcome, or an irritant.
She had just finished her own shift.
‘How is Mrs Collins?’ I asked.
It all seemed a very long time ago. I’d lived several lives since then.
‘I think we’ve managed to save her arm,’ she said. ‘It’s a bit of a miracle, really, that you called when you did. My colleague hadn’t been made aware of the
urgency of the situation.’
I wondered if she was covering. ‘So, are you enjoying it?’ she asked, walking just ahead of me, inclining her head back slightly to talk. A soft grey cashmere cardigan was slung
casually over a black vest and skirt that caressed her sheer black legs just above the knee. Her heels tapped the pavement.
‘Enjoying is probably not the right word . . .’
‘The accident?’ Word had obviously travelled fast. ‘Was it nasty?’
‘Nasty’ seemed like a child’s word for the injuries I had seen.
‘Pretty nasty.’
We’d come to the junction with Tottenham Court Road. She was heading south, and I was heading north.
‘Do you have to be anywhere?’ Charlotte suddenly asked. ‘You look like you could do with a drink.’
It was more of a diagnosis than an offer. Was there some protocol about socializing with senior colleagues? This was Charlotte, I told myself. I’d known her since I was thirteen.
I glanced at my watch. It was long after the pubs had closed.
‘I don’t know where we’d go,’ I said.
She let out a light laugh.
‘We’ll go to my club,’ she said, throwing her arm in the air to stop a taxi I hadn’t even noticed approaching.
The club was one of those chic Soho networking places with a camera entryphone and cool-looking staff on reception. It was thronging with sophisticated types in their twenties
and thirties.
‘It’s mostly media,’ Charlotte told me, as we carved a way through the throng. ‘But someone I know is on the committee.’
Was that someone a man or a woman? I wondered, keeping my eyes on the loose chignon of raven hair in front of me. A man, I decided. Charlotte was too intimidating, not someone I could imagine
with a gaggle of women friends like Lucy. My eyes scanned the cocktail bar, the contemporary art on the walls, the kitchen counter where chefs were working, the specials chalked up on a blackboard
– pumpkin ravioli with sage, slow-cooked pork belly, braised radicchio – trying to take in all the details so I’d be able to fully describe this night-time party world we
didn’t even know existed.
‘Is it always like this?’ I had to shout to be heard.
‘I suppose it’s slightly more
Decline and Fall of the Roman Empire
tonight,’ said Charlotte.
We pushed through a room where people were watching what I initially assumed was a disaster movie on a huge plasma screen.
I stopped for a moment, realizing that the broadcast was coming from an American news channel, the same footage again and again of a plane flying over the heads of a fire patrol and straight
into one of the World Trade Center towers. Then a long shot of both towers: one with smoke billowing from it, the other approached by a plane, as tiny and black as a bird, which flew straight into
it.
‘Holy cow!’ said the reporter, as the entry point erupted.
‘What’s happening?’
Charlotte frowned at me as if she thought I was being facetious, then realized my bewilderment was for real.
‘Oh my God, are you the only person on the planet who doesn’t know? Do you think it’s too cold to go outside?’
‘No, let’s . . .’
Charlotte led me up a narrow flight of stairs with a door at the top which opened onto a roof terrace with soft lights and luxurious garden furniture. The night air was refreshing after the
sweaty heat of drinkers.
A waitress approached as we sank into the deep, linen-covered cushions of a rattan corner sofa. ‘What can I get you?’
‘I’ll have a Grey Goose Martini, very dry, with a twist.’
‘The same,’ I said, when the waitress turned to me.
Grey Goose, it turned out, was vodka, no doubt an incredibly expensive brand. The sting of anxiety about who was going to pay the bill when the first round arrived was soothed by the balm of the
second. The Martinis were viscously cold, the relaxation so immediate, it was the nearest thing I could imagine to mainlining morphine.
As Charlotte recounted as much as she knew about what had happened in New York, I took my second cigarette of the day. She smoked red Marlboros. I remember thinking how ballsy she was. No Silk
Cut or Marlboro Lights for her. Everything about her was cool, I thought, trying not to stare at her lips.
‘I’m surprised they haven’t closed the airspace over London,’ she said.
Our eyes followed the lights of planes dropping silently westwards across the night sky towards Heathrow.
‘Do you think the world’s going to end?’ she asked.
I remember thinking,
What a way to go if it does!
Sipping cocktails with Charlotte, in a magical rooftop world of spires and baroque porticoes which couldn’t be seen from the
street. How amazed Ross would be if he could see me talking to her here, occasionally even making her laugh. And how livid . . .
‘How long have you been a member here?’ I asked.
She considered the question. ‘I suppose a couple of years.’
Not with Ross, then.
I noticed she smoked her cigarettes no more than halfway down, then ground them out decisively, as if telling them – and herself – she didn’t need any more.
‘And your friend? The one on the committee?’
I was at that stage of drunk where I could hear my voice, but it was as if someone else was speaking.
She stretched like a cat along the cushions.
‘You’re not trying to ascertain my personal history, are you, Dr Macdonald?’
‘Not at all!’
‘Do you go to the theatre often?’ she asked.
Such a non-sequitur, I wondered if I’d missed some important chunk of conversation.