Anyone could tell walking into that room that Adnan is mortally sick. His massive figure is sprawled helplessly on the bed, pale and sweating, a CPAP mask over his face. But if you missed the signs, the long list of acronyms on the discharge summary would make it plain in an instant: CKD4, CBBG, IDDM, CCF, AF, OSA and so on – a long, coded parade of woe with an eloquent line-space before the final four letters: DNAR. He was only discharged three weeks ago, but he’ll need to go back. He’s struggling with chest pain and breathing problems, and the family simply don’t have the resources or expertise to cope at home any longer.
Adnan’s son Bashir tells us what we need to know, translating into his father’s ear, and gripping him by the hand. Adnan’s wife, Rema, meanwhile, comes in and out of the room with a succession of things: a clean pair of inco pants, a fresh linen robe, some velvet slippers, solemnly handing each item to us with such a fixed and sad expression it feels like we’re officiating in some religious ceremony – which, by default, I suppose we are.
Together with Bashir we dress Adnan, and prepare him for the ride in our chair out to the ambulance.
Once he’s on the trolley we run through another set of obs. We need to do an ECG, so I undo his robe to the navel. Lying on top of the great, bunched scar that runs down the centre of his chest is a plain wooden cross on a chain. I hesitate to move it aside. It strikes me it’ll probably do him as much good as anything else Still, we go through the motions, sticking on dots, putting in a canula, giving morphine, working around each other in the cramped cabin space.
Bashir sits forward on his seat, squeezing his father by the hand and talking low and quickly.
Okay. Good to go?’ says Rae finally, surveying the scene and pulling off her gloves.
‘Yep. Thanks Rae. I’ll pass the ASHICE from the back.’
She jumps out and slams the door.
I press the Priority button and wait.
Bashir leans over, repositions the cross on his father’s chest, strokes his face, then sits back down again as the ambulance moves off.