Her room was messy. Uncoordinated. Beige. Last night’s beer bottle lay horizontally at the bedside. Empty. Columns of medical textbooks towered across cheaply assembled Ikea furniture. A stethoscope lay at the foot of the bed. The bell pristine. Earplugs clear of wax. Almost as good as new. A message popped up on her phone, from Ivan. She was still asleep.
"I HEAR JERUSALEM BELLS A-RINGING
ROMAN CAVALRY CHOIRS ARE –-"
She slammed the top of the alarm clock. She wasn’t a diehard Coldplay fan, but that song always got her up. She opened her eyes to their full capacity. An immense yellow sheet of light pierced the back of her retina.
Descending the stairs seemed particularly cerebellar that morning. Each step required more effort than the previous.
She could still taste the tequila at the back of her throat.
Her roommate stood eagerly at the kitchen entrance.
“Oh my god! Is he here?”
Never before had she shown such excitement at this time of the day. In fact, she was never up at this time. Why was she up? Did she finally get a job? Did she specifically get up to inquire about my personal life? Either way it was not the time or place to discuss Ivan.
He was tall. Curly. Blonde haired. Eyes as blue as the ocean. She thought about how well the date ended. She remembered how good his kiss was, even for a financial analyst. Why didn’t he kiss me until the very last moment? How many signals does a girl need to give? She remembered his painfully awful jokes.
She glanced at the clock and panicked. Her average commute to work was 15 minutes. Today Dr Ashgard ‘Prof A’ was leading the ward round. 9.00AM sharp and not a minute later. He was a middle-aged man, both egotistical and eccentric. Fitting, but useful attributes for a surgeon. She rushed out of the house. Prof A had a low tolerance for latecomers.
The time was 8.55AM.
She loved the feeling of entering the hospital. It was a small district general hospital, in a cosy little town. Just a few weeks ago she was partying in the city lights and celebrating her new-found title. ‘Doctor’, so prestigious. The reality was she was a single girl in her mid-twenties, at the start of a long career path, and the emotional stability of a drunk chihuahua.
She enjoyed walking past familiar faces on her way to the surgical ward on the second floor: Daisy, her colleague, on her way out after finishing a gruelling night shift; Matt, the nice porter who always smiled as she walked past the main corridor; Tracey, the charge nurse with an innate ability to sense when people were arriving late, hungover.
The time was now 9.10AM.
The ward round had begun. Luckily, they were still on the first patient: Mr Linus, a 54-year-old Jewish man. He had been in and out of hospital following a series of complications after routine surgery. He was too big for the hospital bed. His legs lay hanging over the edge, partially covered by a blanket. His eyes were blue, hiding behind thick-rimmed glasses. The curls of his hair visible under a clear shower cap. A stoma bag was attached to his lower stomach. His bowel motions visible. He was constipated.
She had grown fond of Mr Linus. On numerous occasions, they had conversed about anything and everything: her experiences of roaming through the maze of modern dating; his struggles of reacquainting himself with his estranged family. It was safe to say once someone inserts their finger in someone else’s rectum, the usual social boundaries of conversation don’t apply. She often felt Mr Linus was helping her more than she was helping him. He was depressed. He wanted to get home.
Prof A turned around enthusiastically as she joined the ward round.
“Laura. How nice of you to join us”
She sensed the sarcasm in the tone of his voice. She was late. She nervously swallowed any remaining ethanol-infused saliva into the back of her food pipe. Her heart racing. She longed to go back to her beige room, dreaming of Ivan. She’d rather be at his debut comedy show than face the wrath of Prof A.
“Name the three most common complications of a reverse Hartmann’s procedure?”
Laura realised in order to answer the question she needed coffee, water, followed by more coffee.
“Err... bleeding, infection... and...”
“Anastomotic leak”, piped in Thomas.
She looked over at him. Anger filled her veins. Blood reached her head. He had a small smirk on his face — so small you’d need the Hubble telescope to scientifically verify its presence. Prof A had a similar expression. Similar to that of one who relieves himself of trapped flatus. It seemed distasteful however to think in intestinal humour, given the present company of Mr Linus.
The rest of the ward round went swiftly. It felt like a dance routine. She felt like they were a group of salsa dancers, dressed in white coats, moving to the beat of “How are you feeling? Have you eaten? Good keep going. Next patient”.
The time was 11.30AM.
An early finish to the ward round meant an early start to completing clinical tasks on the ward. Laura felt privileged that attending medical school for six years gave her the opportunity to make phone calls, fill in paperwork and carry out mundane administrative tasks. God forbid she was asked to utilise her in-depth knowledge of human physiology to make decisions related to the medical care of the patients. She made it to the canteen for lunch.
The time was 12.30PM.
Laura had tried dieting for years. Vegetarian, presbyterian and every other -tarian. Her gym membership since the second year of medical school was still active. She made a point to cycle to lectures when weather permitted. She now walked to work and had recently joined a spin class. But there was no better way to get into shape than working as a junior doctor. Breakfast was a luxury. Eating lunch was never guaranteed. Dinner relied on gourmet meals such as beans on toast, or in some instances, just toast. Who needed to pay for a personal trainer, when racking up thousands of pounds in debt and spending years revising for exams, guaranteed you access to the slim-line lifestyle of a healthcare professional.
Today was eerily quiet. Tasks were completed. Nothing was outstanding. The nurses were happy. The patients were stable. The sun was out. Laura managed to step outside. She breathed in the fresh Yorkshire air. She left her jacket inside. It didn’t matter. She felt the warmth of the sun. Her arms felt a gentle breeze. There was peace in the air. She sat on the bench. She could hear the birds chirping. She could hear children laughing. For a moment, she felt at ease. Her mind was empty. Her thoughts were absent. She felt the side of her lips raise slightly. She was smiling. Home time was close.
The time was 3.30PM.
She felt something vibrate on her right hip. It was her pager. A red light flashed on the side. She removed it from her belt. A loud alarm sounded repeatedly. So loud the children in the distance stopped to see where the noise was coming from. A robotic voice began to speak.
“ADULT CARDIAC ARREST. 54 YEAR OLD MALE. SURGICAL WARD.
ADULT CARDIAC ARREST. 54 YEAR OLD MALE. SURGICAL WARD.
ADULT CARDIAC ARREST. 54 YEAR OLD MALE. SURGICAL WARD.”
She felt a lump in her throat. Her heart jumped. She knew what was happening. Someone had just died and needed resuscitating. They needed urgent attention. Who was it? Had she done something wrong? She pulled out her patient list. Had she completed all of the tasks? What did she miss? Who is it? Who’s 54? Her hands shaking, her eyes fixating on the name. Mr Linus.
She ran to the main entrance. She ignored the wave from Matt. She desperately tried to recall the lecture on emergencies. ‘A for airway, B for breathing...’ She ascended up the stairs. She realised this was her first emergency as a doctor. What was she running to? What could she expect? Will there be help? What if she needed to make a decision? What if she doesn’t know anything? What if she’s not ready?
She passed the ward entrance and ran towards Mr Linus’ bed. The curtains were closed. She took a moment to compose herself. She looked outside. The sun was still out. The hills visible in the distance. She felt sick. She had to do this. She pulled back the curtain.
Tracey was towering over Mr Linus, performing deep chest compressions. His bag had opened up and faecal matter was leaking down legs. A Chinese man in scrubs was attaching leads to Mr Linus’ shoulders. Was he a doctor? It was hard to tell. She noticed his nose-ring. Another man in scrubs was grabbing Mr Linus’ throat. He looked Spanish. Or perhaps Mexican. He was attempting to insert a plastic tube into Mr Linus’ mouth. Mr Linus was unconscious. No movement. No heartbeat. His lungs, paralysed. A group of nurses were frantically trying to bring in a trolley with a cardiac defibrillator. Each seemed determined to take charge of the task as not to appear useless.
Thomas was standing at the edge of the bed, syringe in one hand, blood bottle in the other. Both hands had on tightly worn latex gloves, with streaks of sweat visible along the palmar creases. His eyes looked different. They no longer projected confidence. Was it fear? Was it lack of self-belief? The sounds of numerous alarms and shouting appeared more prominent than ever.
“GET THE OTHER PATIENTS OUT...”
“I CAN’T ESTABLISH AN AIRWAY. HE’S NEED INTUBATION. I NEED TO GET MY SENIOR...”
“HAS ANYONE GOT ACCESS YET? WE NEED A BLOOD GAS!”
“WHO KNOWS THIS PATIENT? WHAT’S THE STORY?”
“SISTER WHAT HAPPENED? WERE YOU HEAR WHEN HE LOST CIRCULATION? DOES ANYONE KNOW WHEN HE LOST CONSCIOUSNESS?!”
“GET THOSE PATIENTS OUT! WHERE’S THE MEDICAL REGISTRAR?”
“I’LL GET THE MACHINE READY, YOU GO HELP DAISY WITH THE PATIENTS”
“ARE YOU THE MEDICAL REGISTRAR? WHO’S LEADING THIS ARREST?!”
“I’M THE RESUS NURSE, I’LL TAKE OVER COMPRESSIONS”
CAN SOMEONE GIVE ME AN UPDATE ON THE BLOOD GAS? WHERE IS IT?!”
“I NEED THE NOTES. SOMEONE GET ME THE NOTES!”
“I CAN’T ESTABLISH AN AIRWAY, IS THIS MAN FOR RESUS?”
“WE NEED GO THROUGH OUR H’S AND T’S. HYPOXIA...”
“WHERE THE HELL IS THAT BLOOD GAS?! WHO WAS MEANT TO BE GETTING IT?”
“I THINK DAISY WENT TO GET IT…”
“YOU! WHAT’S YOUR NAME?!”
‘TAKE ANOTHER BLOOD GAS AND GET IT SENT”
Laura stumbled over to the trolley. What syringe did she need? She looked up to see which nurse she could ask. None of them looked back. She looked over at Thomas. He appeared busy. He fitted in. Everyone fitted in. Their presence was justified. Laura felt anxious. The tequila was now replaced with the taste of vomit. She started thinking again. What syringe did she need? Which artery would she need to go to? Femoral or radial? She looked over vacantly at Mr Linus. What would he think? Would he still talk to her? Would he forgive her incompetencies?
“Do you know what you’re doing?!”, she heard from the side of the bed.
Laura paused. “Er...”
“Thomas, perform this blood gas and see if you can’t find the notes. Laura, I suggest you leave and come back when you’re ready. It’s a bit crowded in here”
Her heart sank. She immediately avoided eye contact with anyone else in the room. She could feel the sides of her eyes welling up. Her nose was moistening. She swiftly walked into the corridor and opened the first door she could find. She fell to the ground, with her back against the wall. Tears flushed down the sides of her face. Mucus poured out of her nose. Her lunch now reached the back of her mouth. Her chest tightened, her breath quickened. Her peripheral vision diminished. She knew what was coming next.
The time was 5.15PM
Today had been a murky day. The weather was colder now as winter approached. Laura sat by the window in a desperate attempt to take in any remaining Vitamin D. The bar wasn’t too busy for a Friday. She sat upright, eagerly facing the entrance. A quick glance at the window to check her hair configuration.
‘Bing’, her phone rang. A message from Thomas.
“Hey Laura. Well done on getting the blood gas today during the emergency. So much better this time. See you Monday”
She smiled. She knew Thomas had a softer side. She took a deep breath in. She looked outside at the grey skies. She remembered how she felt sitting on the bench, listening to the birds and the children. She remembered why she chose to become a doctor. She remembered Mr Linus. She imagined he would have been proud. She never got the chance to tell him.
A tall figure entered the bar. She looked up. The curls of his hair matched the wavy pattern on his woolly jumper. His blue eyes were full of mystery and poor jokes.
The bartender walked past. She ordered tequila.