routines

I knock on the door. A dog barks, a door somewhere deep inside the house is opened and then slammed shut; the barking is muted.
An elderly woman with a face as white as her apron opens the front door.
‘He’s upstairs’ she gasps, then stands aside.
We haul up the narrow stairwell with all our bags, and meet a young guy on the landing at the top.
‘I did what I could’ he says. ‘Grandad’s in the bedroom’

It’s a small room. His grandfather is lying on his back in the space between the bed and the wall. Rae pushes the bed as far over to one side as she can. I kneel down next to the patient. No breathing, no pulse. His face is a congested blue, but his body is still warm. I start chest compressions whilst Rae gets out the defib pads. For a second I wonder what’s causing the sharp pain in the palm of my right hand, then I realise that the patient has a staple in the middle of his sternum. I ask Rae to chuck me a gauze pad. When I take my hands off his chest to put the pad there, my rubber glove hangs in tatters from my hand.

A second crew arrives to help out.

---

The resus lasts an hour and twelve minutes. We manage a few shocks right at the beginning, but despite everything we do, the patient drifts away from us along a path of non-shockable rhythms to asystole.
Kerry, one of the supporting crew, goes downstairs to tell the patient’s wife that he has died. After a brief pause we hear a dreadful shrieking moan, and then a flurry of low voices. The dog starts barking again but then just as suddenly falls silent.
The three of us remaining upstairs pick the patient up, put him back to bed and make him presentable. Then we start tidying the room.
I take the resus bag from where it was thrown into the dog basket lying at the foot of the bed and pack the defib away. I open a clinical waste bag and we toss into it all the empty adrenaline phials, pads, caps, swabs, BVM – all the great clutter of stuff that accompanies a resus.

I notice a small whiteboard by the side of the bed. Along the top half of the board is a daily exercise routine written out in blue; some of the words are written in capital letters, some of them have next to them little hand-drawn stars and asterisks. The bottom half of the whiteboard is dedicated to important dates for the rest of the year. December has ‘The Wizard of Oz’, underlined twice, and an exclamation mark.

On the way out of the house we pass by the grandson again who holds the door open for us and thanks us for coming. A large man with silvered hair and a mouth so thin it could have been drawn with a sharp pencil, stands to one side, staring at us. I say to both of them how sorry I am. The grandson closes his eyes and nods. The silver haired man clears his throat, and I hesitate, expecting him to say something. But he remains as impassive as before, so I shoulder my bag, say goodbye and leave.