As we pull up outside the house, I read the patch of garden like some brave domestic flag, the trampled borders and dump of children’s bikes hinting at an on-going battle between family order and chaos. A woman waves to us from the brightly-lit doorway, then folds her arms against the chilly early evening as we climb out and go to her. She smiles, thanks us for coming. A scruffy old terrier waddles out to sniff our trousers. Together with the woman it leads us through to the living room.
A fire flapping busily in a grate. A teenage girl at a laptop. A heavy grey cat draped over the back of a sofa, and a boy of about eleven lying on the sofa, surrounded by cushions, his legs drawn up. He has a mop head of pure white hair, which – along with the rich brightness of his surroundings – makes his pallor seem all the more striking. He smiles and waves. The cat looks up, licks a paw once, then settles down again.
The girl stops emailing at the laptop, swivels round on her chair and says: ‘I gave him a magic shell, but it hasn’t worked.’
The boy holds the shell up so I can see it. A dog whelk. I examine it.
‘Hmm. That’s a great shell. You must be poorly.’
The father comes over and kneels beside his son. Two more girls come pushing each other and giggling into the room. The mother puts her arms round them and then they all stand quietly as the father brushes some loose strands of hair from the boy’s face. Even the dog comes and sits down to the side of him, a storybook family gathering to bear witness to the story of Edward’s illness - the central abdo pain, first in the morning, some nausea, easing off, then coming back on strongly this evening. It could well be appendicitis, but whatever the cause, a trip to the hospital is in order.
The family disperse noisily to get what needs to be got. The boy groans, but does everything he can to help.
Only the cat remains in place.
Seven hours later. We are flying through the early morning, a low strobing swoop through darkness. The wheels of the ambulance give little skips around the bends as I push the vehicle on. We are the nearest vehicle to this cardiac arrest, and we are eight miles away.
Our satnav has given up; Tony is reading the map like a rally driver.
‘Left! Left! Left!’
‘At the next junction – right!’
Finally, the block of flats appear along to our left, set up from the road on a steeply raking bank of concrete steps. Access must be round the back, but just as I decide to carry on round, a woman comes double-stepping down, waving her arms, so I stop. Tony buzzes the window.
‘Come up this way. It’s a little bit quicker,’ she says. Calm and controlled.
Gloves. KRS and key out. Obs bag and chair. Tony hauls out the resus and drugs bags. Laden like pack mules we climb the stairs behind the woman as she tells us the story. She lives next door. Her friend knocked her up and said they were having trouble with Peter. Peter is thirty-six and suffers with epilepsy occasionally, but that’s all as far as she knows. Peter’s friend John had been sleeping with him tonight, got up to go to the loo. When he came back he realised Peter wasn’t breathing. Nobody knows for how long. As she shows us into the front door of the building, held open with a welcome mat, she tells us the father is on his way and should be here in about half an hour.
Inside the flat we negotiate a route through heaps of boxes and bin bags to the bedroom. Familiar signs and smells of neglect. Two men sitting on a sofa in the living room – both smoking, both looking out at us with a mildly disappointed air, like we’re simply the latest damned thing to happen.
We see Peter lying on his back on the double bed next door, his arms outstretched and his legs crossed, sheets rucked up, a ghastly figure, the pastiche of a sulky sleeper looking for five more minutes and finding an abyss.
We go in - and then the resus progresses as they always do, moment through moment, action on action, as familiar but still unique as a new hand of cards: we play the dragging to the floor, the compressions; the read-outs; the ventilations; the drugs; the second crew arriving on scene (our most valuable card) – laying out each move as best we can as the digital clock on the defib relentlessly marks time and the cardiac readout rolls out each assessment – flat, flat, flat. This was a bad hand from the start. And to make things worse, the patient had aspirated significantly before we arrived. Awful, underground gurgles sound ominously with every compression. It’s like pumping up and down on a water bottle – which suddenly blows. A quantity of blood bursts from the patient’s nose and mouth; it sprays out from under the mask, and despite Tony’s quick pulling back, splashes onto his trousers. Where is it all coming from?
‘Eurgh!’, he says, and holds off, partly in shock, and partly because this would seem to be the final show – if one were needed – that this resus is terminal. Blood pools in one of Peter’s half-opened eyes. Twenty minutes have passed. We agree between us that we should stop.
Then the woman who showed us up to the flat comes in to the room. She says she has Peter’s father on the phone again. He says he wants to talk to a paramedic before he sets off. One of the second crew takes the phone from her and walks into another room to tell him that his son has died. When he comes back into the room, he tosses the phone onto the bed.
‘He says there’s no point in coming now. He’ll wait for the inquest.’