Sunday, August 14, 2005

Imagine a peaceful river...

Another long absence, this was meant to be a nightly thing.

And night it is. Eleven oclock, the family in bed, the dishwasher and the numerous cats purring, and me full of that post-breakfast high as everyone else settles in for the night.

Lots been going on.

First off, not for the first time I wish I didn't have to be anonymous in this thing, because I have some quite gloatworthy news. In my idle hours I write stories. A year or so ago I came home from nights and hammered out an eight-hundred word story and sent it off to an internet magazine. They don't pay but the editor seems like a nice guy, we have promised each other a beer if we are ever in the same state, and it is supporting Australian SF/fantasy/horror. Good looking site too.

Anyway, a few months ago I got this call from this guy and he's editing an anthology of the year's best stories and he wants me in it. Me along with this guy called Terry Dowling (one of my all-time favourite authors) and several others. Australian SF is a small pond, but within this small pond there are several biggish names, and they are in this book.

And so am I. First professional looking publication, the first actual book. I've got a copy of it here now. I was so excited I rang a series of three people:

First phone call (ten forty three pm)
Me: Guess what! My God! I can't believe this! Oh my God! I've got the book! I've got it here!"
Him (appropriate glee and praise)

Second call: (ten forty eight pm)
Me: I've got it! The book! I've got it here, I'm holding it! My God!
Her (appropriate noises, goes back to sleep)

Third call: (ten fifty two pm)
Me: God! Guess what I'm holding! Guess what I've got in my hand! Oh my GOD!"
Her (suspicious): ...who is this? why are you calling me?

Well, it was funny at the time.

Anyway, a story in the book, a poem in consideration in a good Australian SF magazine, several stories yet to be rejected... things are looking good. If the poem gets published I may post it here, if I can.

What else. Well, for the first time I was in charge overnight at Florey.

And lo, the sky did not turn red as blood, and an angel of death did not move amongst the scattered people of Fang Rock and South Slytherin, and the Lord did not send plagues of boils and carbuncles and strange fits to discomfit mine patients.

The Lord sent an alcoholic who woke up in the ED and grabbed the nearest bottle and down it, thereby depriving us of about 250 ml of betadine antiseptic wash, and a woman who I sent off to ICU with a provisional diagnosis of Some Weird Shit Happening (deeply strange arterial blood gases, breathing like a bellows, no meaningful history because she was confused and sick and her husband was, sorry, bargain basement stupid), and a series of nervous women with chest pain.

But none of the chest pains turned out to be cardiac, and the Lord did not send me a choking baby, or a septic kid, or a woman in end-stage labour (well, He did, but we diverted her to maternity), and the Lord did not cause any of my psychiatric patients to wax wroth or any of my inpatients to take overdoses. Except of betadine antiseptic wash.

Right. Here goes.

A few days ago, almost a week, a Bad Thing happened.

The following is very bad stuff. The usual warnings apply.

A friend of mine was triage nurse. Triage is the worst nursing job in the hospital. You get to sit behind this big thick glass screen (recently installed) with a security guard (recently installed) behind you, and it's your job to assess people in order of urgency and let them in according to the ED capacity.

Since we are almost always running at full capacity, this means people have to wait. And waiting times can be horrendous - the six hour wait for priority fours a fortnight ago was not even remarkable, the ten hour wait the last night I was senior on at Shipman was more like it. So Pam (brisk, slim, early forties, northern English, remarkably competent) is there and there's a lineup, five people waiting in various stages of irritability because they haven't even got to triage yet and the waiting room has fifty people in it. Here's her writeup:

1744: 44 y/o man with eyepatch, welding, now c/o flashburn. No safety glasses but denies foreign body. P4

1746: 16 y/o, playing football, eversion injury R ankle, able to weight bear. P5

1747: 88 y/o woman, some lower abdominal pain, no nausea/vomiting but anorexic, constipated five days. P3

1750: 22 y/o woman, unprotected intercourse three or four days ago, seeks emergency contraception. P5.

And 1751 was this skinny, dirty, tired looking woman clutching a little bundle over her shoulder, occasionally patting it. She looked up at Pam and said "I think my baby's not breathing".

Things exploded from then. I can't communicate how fast things happened and how slowly they seemed to happen. I was out the back, they called a paediatric code blue, I heard the buzzer and since I was closest to resus I was first doctor out there.

Pam had laid the baby on its back on the resus trolley, started CPR, but it didn't look like a baby. It looked that dull, pale, plastic colour, like a lifelike doll. When you do CPR on a baby it's tiny movements of a single hand or a few fingers. We got high-flow oxygen going, then the consultants arrived, Dr Quinsy, Dr Shingle and Dr Blight, and all of a sudden the room was full.

Paeds reg and paeds consultant turned up and I got out of there, but I kept coming back to see now things were working out. They worked in there for three hours. The kid came in dead and they got him back and he died again and they got him back - tiny heart spasming in useless movements, no blood flow beyond us pressing his tiny chest - and he died again - and by God after three quarters of an hour they got him back. And the tranfer team from the Princess arrived and they took him down the road.

And in the end they couldn't hold him.

And an hour after that Dad's heroin had worn off and he turned up asking why we'd called him.

Why am I telling you this? I don't know. It's none of your business.

Tell you what. This is what I fear. The sick child.

Sometimes I get a clearer image of what is ahead. I have practised medicine for four years. No complaints upheld against me. No legal actions. No-one who died who really wasn't going to die anyway. No dying child who won't breathe.

But this is all coming. I know if you roll a dice enought times you get a six, if you keep spinning the chamber and pulling the trigger, a bullet will find you. Sooner or later, that's going to happen.

Once or twice in my life I've had this thing like they write about in books, things you see before you when you close your eyes, things that come into your head unbidden. That baby boy, the colour and look of plastic.

I feel as a certainty that is coming. I don't know. It won't be that, it may not be a baby. But you stay in this long enough, there's going to be something that you do wrong. You have to cope with that. You have to think of the good you do. But that is the shape of my fears.

But the first few days after that happened I couldn't get that image out of my mind. Christ I wish we could have done more. These aren't sensible thoughts, I know. But I have ideas of this happening on my shift. I don't know. I get this idea of a preventable death, something involving a baby, and then there's just this blank, this scene where I just go, leave, stop all this, get on a bus and go into the desert.

I don't know, he says for the hundredth time. This doesn't make any sense to me, to any conscious part of me.

Rather than write and reveal more I am going off to sleep.

Thanks for listening.


Anonymous Camillhu said...

I really can't think of any words to describe how I felt after reading this entry. I'm glad there are people like you who are doctors.

9:22 PM  
Blogger Benedict 16th said...

Nothing much sayable here either,
Come on over and drink beaucoup de vin rouge and we can swap horror stories... about
Dr -1x(Frownie) and Dr -1x(Celebrate) and my stories of the North...
(can't say I have any kids stories worse than my time there)... And I'll show you pix of the foilsprogs...

I think we need to catch up IRL

Benjamin XVI (madder and badder than the XVth)

11:43 PM  

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