He was barely breathing when they brought him in.
I started work immediately: protecting his airway; assisting his feeble respiratory efforts; checking his pulse. Airway, Breathing, Circulation. As easy, and automatic, as ABC.
Next I started intravenous fluids. Finally I was ready to examine for signs of injury.
The most obvious abnormality was the ring of fire around his throat; the blotching on his face. Multiple facial petechiae consistent with asphyxiation, I wrote.
Lastly I observed the broken fingernails where unbound hands had clawed at the noose. Presumably this was an involuntary reflex, the body resisting what his will was attempting.
This initial resuscitation had taken ten minutes. Yet even in that brief period the atmosphere had frozen so solid I could have carved off a chunk and put it in my off-duty beer. Every order had been sloppily obeyed. Everything I requested had been slow to arrive. I decided to ignore it.
‘Arterial bloods please.’ I addressed Claire, a keen young doctor on my team.
Venom spat from her eyes as she drew the pulsating crimson sample. Casually she removed the needle and turned away.
‘Claire!’ An enlarging red circle marked her handiwork.
She shrugged. ‘His heart’s pumping, then.’
I seized a swab and began compressing the artery. ‘Will you draw some venous blood, too?’
‘If you like,’ her indifferent shrug denying her sour expression.
I watched her yanking the tourniquet. ‘No, leave it. I’m relieving you of duty. Wait in my office.’
She dropped the equipment as though it was burning her, and turned on her heel. With my free hand I leaned over and released the tourniquet.
With the patient stabilised and entrusted to the care of a very reluctant ward team, I dragged myself to my office, as anxious as if our positions were reversed.
She stood, hands in pockets, truculence written large across her face.
‘Claire, do you want to tell me what’s going on? I’m astonished at your behaviour.’
‘Quite honestly, Dr Grainger, I’m astonished at yours.’
‘At my attempts to save the life of my patient? Successfully, I might add. Thanks for asking.’ I sat behind my desk, trying to contain my temper.
‘But he’s not just any patient, is he?’
‘No, he’s an individual. We don’t treat generic patients in this hospital.’
‘You know what I mean. Some people’s lives shouldn’t be saved. Some people aren’t worth the cost of the treatment.’ She held my eye.
‘And he’s one of them?’
‘Well, how will you feel when he’s caught abusing another child?’
‘I’d be appalled. But that’s not my responsibility.’
‘Isn’t it? I think it’s very much your responsibility.’
‘What about the lorry driver you save who mows down a family picnic? Is that your responsibility?’
‘That’s different. It’s unpredictable. It’s nothing to do with me.’
‘And neither are this man’s crimes, past or future. All that matters is that when he’s brought in we do our best – our very utmost – to save him. That’s what we took the Oath to do, remember?’
‘But he wanted to die. He hanged himself.’ A plaintive note was creeping in. I knew I was winning.
‘Do you say that about every suicide attempt who comes in?’
She shook her head. ‘Of course not. I always do my best for…’
‘Yes, you do.’ I leaned over and took her hand. ‘You’re a good doctor, Claire. You were caught unawares today. But you must learn again that every human soul is valuable. And our mission - our holy task - is to protect and defend its fragile shell.’
She nodded slowly, sadly. ‘It’s hard. When everything inside you wants to scream, to hurt. It’s very hard.’
‘Yes, it is hard.’ I take off my glasses and wipe them slowly. ‘It’s nearly the end of the shift. Go home and get an early night. Tomorrow’s another day.’
‘Thank you, Dr Grainger.’ She paused. ‘You’re a good doctor. I’m honoured to work under you.’ She was gone.
I polished my glasses some more. I hoped I was a good doctor. I always tried to serve my patients remembering the residual image of God that they bore, no matter how depraved or disfigured.
It had been a long journey. A long journey of recovery. God had been growing his grace within me, because he’d known how much, today, I would need it.
The last time I saw that man, I was twelve. He was in the dock and I was in the witness box.
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