the first time

Rae drives with supernatural incisiveness, powering through the heavy morning traffic, anticipating with cool clairvoyancy the smallest deviation or hesitancy, flashing through gaps with a paint sweat of clearance, braking down before that driver even thought to indicate left and pull over to the right. We are heading out to a fifty year old female in cardiac arrest, and we want to get there quickly.

Swinging round into the close we can see the house we want: the one with the door open and a naked man pacing about on the grass verge outside. He holds a phone to his ear with one hand, the other the ends of a bath towel he has bunched around his waist. He flips the phone shut as we pull up.

‘Please, please be quick. She’s upstairs on the bed and she’s not breathing or nothing. Please, please, please, oh god. oh god.’

As I stride across the grass with the resus bag I ask him questions. He says his wife has a history of angina. She complained of chest pain when she went to get up this morning, but keeled over before she’d had time to grab her spray.

Inside the house and it’s horribly cluttered with junk. I wonder how we’ll fit the chair down these stairs, but immediately focus on the scene in front of me as I pick my way across the landing into the bedroom - an elderly man, pushing up and down on the chest of a naked woman sprawled on a double bed. Her body bounces lifelessly as he tries to compress her chest. He stops as soon as he sees me.

‘Help’ he says.

It feels like I’m climbing through some kind of waste facility. There are heaps of old clothes, boxes of video tapes and newspapers, chairs with dusty television sets and VCRs, lino squares and carpet off-cuts.

‘We need to get her on the floor,’ I tell the man. ‘Help me clear a space.’

In a few seconds we pick up and throw across onto the other side of the bed an occasional table with an overflowing ashtray and spilled packets of sweets and just enough boxes to make room for the patient. Rae is in the room now and she cheats the bed over to one side by another critical inch, just enough to get the patient down on the floor. I start chest compressions whilst Rae gets out the defib. The elderly man – the woman’s father – scrambles out of the way over the bed, and goes to stand with the husband on the landing. A technician working on the response car turns up to help. He fetches some extra pieces of kit we need, then takes the two of them to one side to get the paperwork going.

The readout is good for a shock. Rae hits the button. The patient gives a convulsive jerk and her head whumps back on the dirty carpet. I compress her chest for a further minute then we check the readout again. She has a pulse on the screen. And, crucially, at the neck. Her abdomen positively quivers with it. It’s fantastic to see. She starts to gasp beneath the mask with crude, primal intakes. I support these with the BVM.

After twenty minutes we have her wrapped in a blanket and on the chair ready to go. In those twenty minutes the father and the husband have cleared a path for us down the stairs. Fear lends them strength. Adnan, the technician, bussing our kit from the scene and making the ambulance ready, tells us that the father picked up an entire bookcase by himself.

We run the patient out to the vehicle and transfer her on to our trolley. Although she’s still unconscious, her vital signs are encouraging, with a respectable blood pressure and saturations. Rae passes the ashice and we set off for hospital. Adnan follows on with the husband and father.

***

I can see them now, standing side by side in the dirty frame of the bedroom door, the husband holding on to his towel, the father intensely still, watching us as we work. It seems to me that they were standing together at the edge of some new and extreme margin, the outermost point of their lives together so far, where the solid earth they had built their home upon had inexplicably given way to a great gulf of black water. They had watched us struggle to drag their wife and daughter back from this terrible place.

And this time – the first time, for me – we managed it.