I park the ambulance as close to the EMI unit as possible so we don’t have far to walk in this downpour, but by the time we’ve pulled all the equipment we need out of the back of the truck and jumped across all the puddles in the driveway, we’re soaked.
‘God that’s awful!’
We take what shelter we can from the little canopy over the door, until one of the care staff opens up for us.
‘Follow me,’ she says. ‘Stella has a DNAR.’
She leads us through a couple of security doors, then down a corridor with a carpeted floor that gives a little and creaks as we walk. Past closed doors with colour-copied pictures of each resident sellotaped below the number; past the nurses’ station, the sluice, the laundry. Past the games room, where a number of residents are sitting in small groups quietly playing cards or board games, or painting pictures. They don’t look up as we pass.
‘Here we are.’
The carer knocks and shows us in.
Stella is lying on her back on the bed, making feeble, agonal gasps. She’s terribly emaciated, her arms and legs drawn up, all the hollows of her body accentuated, the mortal structure of it, the iliac crest of her hip pushing up beneath a meagre covering of skin.
‘Could we see that DNAR please?’ says Rae. The manager – a small, powerfully-built man with the air of someone more used to receiving forms than handing them out – passes her the red-margined document.
‘Dated and signed,’ he says. ‘As you can see.’
‘Fine. Thank you.’
Stella’s gasps fade to nothing as the arrest proceeds.
‘Shall we sit her up?’ says one of the carers.
‘No. I don’t think so,’ says Rae.
She feels for Stella’s pulse, then takes out her stethoscope and listens to her chest. I stick on some ECG dots and watch the line run flat on the printout, clear and unequivocal.
After a moment or two, Rae says: ‘Stella has died now.’
I write the time down.
Rae questions the staff about the sequence of events whilst I tidy up the equipment and start filling in the ROLE form.
The room is stuffy and foul-smelling. Stella collapsed on the toilet, and the faecal smell, along with the heat from the radiators and the heavy, plaid curtains drawn across the windows, gives the room an unpleasantly closed-in feel.
‘Let’s finish this paperwork in the office,’ says Rae. We leave the carers to clean Stella up, and follow the manager out into the corridor.
He leads us back to the nurses’ station, where Rae rests on the counter to finish up.
‘Would you like a cup of coffee?’ says the manager.
‘That’s very kind, but we’re fine, thank you.’
‘Yep. Thanks. Almost done.’
The station is just a long, narrow recess with a series of windows along the back that look out onto an overgrown garden. Even though the rain is still coming down hard, there must be a break in the cloud, because the room is suddenly swept with a clear, hard light – so intense, that every detail in the office stands out, like a painting on a broad canvas: the browning tips of a potted dracaena, a black SuperDry jacket and black nylon satchel hanging on a hook; an old style fax machine with a note that says: Feed sheets separately; a drugs company calendar with a cute quote about doctors for May; a shelf above a low filing cabinet with a bag that says in big red letters: Emergency Bag, and underneath, taped to the front of the shelf, another sign, saying Emergency Bag, in blue, with an arrow pointing straight up.
The burst of sunlight passes, and the room becomes dim again.
Rae finishes the paperwork.
She hands him the forms.
‘Thank you. We’ll notify the doctor,’ says the manager. ‘I’ll show you out. You need the code.’
We follow him back along the corridor.
Everyone in the games room is sitting as before, the patients absorbed in their games, the staff encouraging them. One of them looks up from his hand of cards as we pass.
‘Thanks again for all you’ve done,’ says the manager, holding the front door open for us.
It’s pouring outside.
We move as fast as we can, but our gear slows us down. We stow the bags, slam the doors, squeal as we jump in the cab.
But we’re safely out of the rain now, the wonderful, tumultuous rain, roaring and rattling a few inches above our heads, on the roof.