The woman is doing well, with the phone squashed to her ear with her left shoulder to free up her arms as they push up and down on her friend’s chest.
‘They’re here’, she sobs into the phone, then throws it into the corner of the room where it lands without a sound amongst the piles of clothes, shopping bags and accumulated junk.
‘They’re here’, she sobs into the phone, then throws it into the corner of the room where it lands without a sound amongst the piles of clothes, shopping bags and accumulated junk.
‘Help me.’
There is only just room enough to step over the body on the floor to get to her. I touch the woman on the shoulder; she stands up with difficulty and staggers over to the window, to join a man who is standing there wiping his face vigorously as if he were trying to wake up, pacing to the left and the right.
Malcolm asks them if there are any needles around. The woman says only one, and points to the sofa. The man begins pulling at his hair and groaning.
‘So what can you tell me about him?’ I ask them. ‘What’s happened here?’
The woman says that she spoke to John on the phone about an hour ago. He was fine then. When she got back to the flat with the shopping, she found him slumped back on the sofa, as blue as he is now. The other man was on the mattress in the other room. They had shared a needle of heroin, but she said that John had been off the stuff for a month, and was maybe not as used to it as he once was. He is thirty four. A touch of asthma sometimes, but otherwise fine.
I stop compressions briefly, to help Malcolm visualise John’s vocal chords and introduce the ET tube. He attaches the BVM and oxygen, and we plough on with the resus protocol. Malcolm tries to cannulate him, but has problems finding a useable vein. He swears quite a bit. We have no room to work, the flat is stifling and rank, and the other man is looking increasingly volatile. Although the woman is hugging him by the window, he keeps repeating: ‘Is he breathing yet?, then moaning, and slapping his face.
‘They’ll tell us when he is,’ she says to him, then to us, with much less certainty: ‘You can’t let him die. Please.’
John is completely inert. His face has the shadow of death upon it – a ghastly blue-grey hue, his lips purple. I cut his T-shirt off, straight up the middle, and then as I continue with chest compressions, Malcolm puts the defibrillator pads on. We watch as it prepares itself to monitor, then I come off the chest to watch the pattern it displays.
‘Asystole,’ he says; the flat line that trails ineluctably across the screen, the bleakest horizon imaginable. The prognosis is unlikely to be good.
‘Is he breathing yet?’ The voice grinds metallically with aggression.
We ask them to go into the next room to give us space to do what we need to do. When they are safely out of the way, Malcolm looks at me and asks the time. We work out that we have been struggling with John now for twenty minutes.
‘Let’s give him a couple more rounds, but this isn’t going anywhere.’
The call had come through to us as a cardiac arrest for a young man, but the call taker had no idea that this was drug related and potentially dangerous. For any death at home we have to notify the police, but in this situation we know that his friend could well take the news of his friend’s death badly. To make things worse, we both realise that in the rush to get up here we have left the radio in the truck. Malcolm asks me to go down there – to tell the flatmates that I’m off for an essential bit of kit – but in reality to call for police back-up urgently.
When I come back into the flat carrying my little red bag, the woman throws me a weak smile, as if I’m coming in with something that might finally save her friend. She follows me back into the room, whilst the other man shadows close behind her like he’s waiting for a word or signal. He has a bottle of white wine in his hand and he drinks about a third straight off.
I join Malcolm back on the floor. We make a play of checking the monitor one last time, but nothing has changed. We both stand up. The police will get here as quickly as they can, but we know that we are exposed. The woman has her hand to her mouth.
‘I’m sorry. There’s nothing more we can do.’
She releases one awful, belly-deep cry. The man takes a step to come round her, and for a second I wonder if he is about to attack us. But maybe hearing the definitive news that his friend is dead is some kind of release for him; the volatility we were so wary of seems to ebb. He stares for a moment at his friend on the floor, as if he was amazed that he could sleep with so much going on around him. Then he turns and walks back into the bedroom, slumps down onto the edge of the mattress, and takes another long pull from the bottle. The woman goes to stand beside him. We tell them what to expect next. She begins crying quietly into a filthy handkerchief. We hear heavy footsteps running up the stairs.
--
Down in the street, the afternoon is bright and busy. There are a few people watching the scene, wondering what the ambulance and police cars might mean. I throw the bags of equipment in the back, slam the doors and walk back round to the cab. I notice that the flat is opposite a church, which has a board outside that says: Come, join your prayers with ours.
We return to base, re-stock, then get sent straight back out to deal with an elderly fall at home. He is fine – just needs a hand back into the chair.
There is only just room enough to step over the body on the floor to get to her. I touch the woman on the shoulder; she stands up with difficulty and staggers over to the window, to join a man who is standing there wiping his face vigorously as if he were trying to wake up, pacing to the left and the right.
Malcolm asks them if there are any needles around. The woman says only one, and points to the sofa. The man begins pulling at his hair and groaning.
‘So what can you tell me about him?’ I ask them. ‘What’s happened here?’
The woman says that she spoke to John on the phone about an hour ago. He was fine then. When she got back to the flat with the shopping, she found him slumped back on the sofa, as blue as he is now. The other man was on the mattress in the other room. They had shared a needle of heroin, but she said that John had been off the stuff for a month, and was maybe not as used to it as he once was. He is thirty four. A touch of asthma sometimes, but otherwise fine.
I stop compressions briefly, to help Malcolm visualise John’s vocal chords and introduce the ET tube. He attaches the BVM and oxygen, and we plough on with the resus protocol. Malcolm tries to cannulate him, but has problems finding a useable vein. He swears quite a bit. We have no room to work, the flat is stifling and rank, and the other man is looking increasingly volatile. Although the woman is hugging him by the window, he keeps repeating: ‘Is he breathing yet?, then moaning, and slapping his face.
‘They’ll tell us when he is,’ she says to him, then to us, with much less certainty: ‘You can’t let him die. Please.’
John is completely inert. His face has the shadow of death upon it – a ghastly blue-grey hue, his lips purple. I cut his T-shirt off, straight up the middle, and then as I continue with chest compressions, Malcolm puts the defibrillator pads on. We watch as it prepares itself to monitor, then I come off the chest to watch the pattern it displays.
‘Asystole,’ he says; the flat line that trails ineluctably across the screen, the bleakest horizon imaginable. The prognosis is unlikely to be good.
‘Is he breathing yet?’ The voice grinds metallically with aggression.
We ask them to go into the next room to give us space to do what we need to do. When they are safely out of the way, Malcolm looks at me and asks the time. We work out that we have been struggling with John now for twenty minutes.
‘Let’s give him a couple more rounds, but this isn’t going anywhere.’
The call had come through to us as a cardiac arrest for a young man, but the call taker had no idea that this was drug related and potentially dangerous. For any death at home we have to notify the police, but in this situation we know that his friend could well take the news of his friend’s death badly. To make things worse, we both realise that in the rush to get up here we have left the radio in the truck. Malcolm asks me to go down there – to tell the flatmates that I’m off for an essential bit of kit – but in reality to call for police back-up urgently.
When I come back into the flat carrying my little red bag, the woman throws me a weak smile, as if I’m coming in with something that might finally save her friend. She follows me back into the room, whilst the other man shadows close behind her like he’s waiting for a word or signal. He has a bottle of white wine in his hand and he drinks about a third straight off.
I join Malcolm back on the floor. We make a play of checking the monitor one last time, but nothing has changed. We both stand up. The police will get here as quickly as they can, but we know that we are exposed. The woman has her hand to her mouth.
‘I’m sorry. There’s nothing more we can do.’
She releases one awful, belly-deep cry. The man takes a step to come round her, and for a second I wonder if he is about to attack us. But maybe hearing the definitive news that his friend is dead is some kind of release for him; the volatility we were so wary of seems to ebb. He stares for a moment at his friend on the floor, as if he was amazed that he could sleep with so much going on around him. Then he turns and walks back into the bedroom, slumps down onto the edge of the mattress, and takes another long pull from the bottle. The woman goes to stand beside him. We tell them what to expect next. She begins crying quietly into a filthy handkerchief. We hear heavy footsteps running up the stairs.
--
Down in the street, the afternoon is bright and busy. There are a few people watching the scene, wondering what the ambulance and police cars might mean. I throw the bags of equipment in the back, slam the doors and walk back round to the cab. I notice that the flat is opposite a church, which has a board outside that says: Come, join your prayers with ours.
We return to base, re-stock, then get sent straight back out to deal with an elderly fall at home. He is fine – just needs a hand back into the chair.
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