enough oxygen to keep cells alive? Jennifer looked upwards. She couldn’t see the bag of saline in the darkness but she could picture the steady drip of fluid entering Digger’s veins. It was such inadequate treatment for the condition he was in.
If the internal bleeding continued, he would enter irreversible shock within the next few hours. Lack of oxygen-carrying red cells would cause the major organs like kidneys and heart and brain to fail. If they had been in an emergency department, it would be so easy to do what was needed. X-rays and ultrasound. Aggressive fluid replacement. A proper chest decompression. A quick trip to Theatre to have the source of the abdominal blood loss fixed.
The isolation of their situation was suddenly overwhelming because it was going to cause someone’s death, and there was absolutely nothing Jennifer could do about it. Her sigh was heartfelt.
‘What’s the matter?’
‘Nothing.’ Nothing new, anyway. Jennifer sighed again. ‘Everything,’ she corrected herself. ‘This is so frustrating. I know what should be done and there’s no way of doing it. It’s…just awful.’
‘You must be pretty used to awful things. How many cases a day would you put through your ED? Dozens? Hundreds?’
‘Somewhere in between. But that’s different. Sure, we lose patients and it’s awful sometimes, but at least we’ve done everything we could and we get to save people who wouldn’t make it without us. People like Digger.’
The silence suggested that Guy didn’t want to discuss Digger’s obviously bleak prognosis. When he spoke, he almost sounded as though he was having a conversation at a cocktail party.
‘So, what’s the most awful case you’ve ever had to deal with?’
‘It’s never nice to lose a patient. You must know that.’
‘It’s different for me. I know most of my patients on a personal basis. Even something as mundane as a cardiac arrest is awful, but it doesn’t happen too often fortunately. You’d get far more interesting things to deal with. So what’s the worst you can think of?’
‘This isn’t exactly a happy topic of conversation.’
‘Maybe I don’t feel happy,’ Guy responded. ‘Or maybe I need to think about other people who are even less fortunate than me. I’m curious anyway. You have a very different perspective on medicine than I do these days, so it must take something pretty major to stand out as being memorably awful. Humour me. What constitutes really awful for you?’
This, Jennifer wanted to say. Lying beside someone who could be saved and isn’t going to be. Having the person who probably loves him more than any other lying on the other side. Being connected by their physical proximity and the enormity of their predicament. Knowing that when there was absolutely nothing more they could do for Digger, the distraction of caring for someone else would be lost and she would have to face the fear of her own chances of survival.
Instead, she drew in a deep breath and spoke quietly. ‘There was this woman a couple of years ago. Lucy, her name was. She was thirty-five and she and her husband had been desperate to have a baby for years. It took about six attempts but IVF finally worked and she became pregnant with twins. Seven and a half months pregnant. They went out shopping for a double buggy and while they were walking along a path, Lucy spotted this puppy in a pet-shop window. She stopped abruptly and turned to have a look, but this kid had been coming up behind on a skateboard and he barrelled into her.’
Jennifer paused to take another breath. Digger mumbled something and jerked his head but then lay still again.
‘And?’ Guy prompted. ‘What happened? Did she miscarry?’
‘No. She stumbled and fell sideways into the path of a car. Severe head injury but she was still alive when she arrived in ED. She arrested shortly after arrival so I decided to do an emergency Caesarean to try and save the babies. Her husband, Matt, was right outside the door of the resus room.’
Even now, the memory was enough to create a painful lump in her throat. What had she been thinking of, agreeing to tell such an awful story? Jennifer blinked hard and doggedly carried on.
‘It was a circus. We had dozens of people rushing in and out. We had to tube Lucy and keep CPR going. We had obstetric and paediatric and neurology staff arriving, and every time the door swung open Matt got a glimpse of what was going on. He saw his wife being cut open and his babies being resuscitated. And then…then I had to go and tell him that we had failed. He’d lost everyone—his whole family. His whole reason for living.’
Long seconds ticked by before Guy broke the new silence. ‘That’s worse than awful,’ he said finally. ‘It’s a truly heartbreaking story.’
‘You did ask,’ Jennifer reminded him.
‘OK, so tell me about the best case you’ve ever had,’ he commanded.
‘There’s been lots of those as well.’ Jennifer was thankful to turn her thoughts to something positive. Maybe the reminder of just how dreadful events could be for others hadn’t been such a bad thing after all. ‘One of my favourites was a three-year-old girl who came in under CPR. She had fallen into a river but we weren’t sure whether she’d arrested because of drowning or hypothermia. It was the middle of winter and she was unbelievably cold.’
‘A “not dead until you’re warm and dead” case?’ Guy suggested.
‘Absolutely. It took thirty minutes to get her core temperature above 30 degrees Celsius and she was still in asystole. Her parents were quite convinced she was dead. We defibrillated her finally. It took three goes but we got her back.’
‘Brain damaged?’
‘No.’ Jennifer was smiling into the darkness. ‘She came into the department a week later with her parents, carrying a big bunch of flowers for me.’
‘Have you got kids of your own?’
‘No.’
‘Planning on some?’
‘That’s a rather personal question. Why—are you?’ ‘Definitely not.’
‘You sound very sure about that.’
‘I am. I like my life just the way it is. There’s no space for kids in it.’
‘So what makes you assume I want a family?’ Jennifer was frowning. Did she want a family? It wasn’t something that had been more than a fleeting thought over the years. A thought that was easy to shove on the back burner due to the precedence her career had always taken. ‘Not all women are born with the desperate need to reproduce. Maybe I’m just as sure about it as you are.’
‘You just gave me the impression that you’re fond of kids, that’s all.’
‘How on earth did you reach a conclusion like that?’
‘Both your worst and best cases involved babies and children.’
‘I guess those cases can be more memorable. Maybe it’s more of a tragedy to lose babies and children than older people who have had a chance to live life.’
‘Like Digger, you mean?’
‘No,
