last delivery

The garden centre is on the outskirts of town, high on the edge of a ruck of ground, its pointed canopies dark against the sky.

Man collapsed. This has to be a member of staff. The place won’t have opened yet.

Rae swings the ambulance round into the broad and empty car park, up towards the glass frontage of the building. There is a man standing just off to the right of it, and he points with a straight arm off to his left, to a track that runs around the side of the building.
‘He’s in the loading bay,’ he says as we draw level. The only way to get there is to go back out of the car park and drive round, but that’ll take a while, so I jump out, grab the resus bag from the back, and tell Rae I’ll see her there.
‘We’ve been unloading the lorries this morning,’ the guy says as we walk quickly, side by side. ‘This was the last delivery. The driver fell asleep in the cab and we can’t wake him.’
There’s one lorry parked with its cab towards us at the end of the track. I can see the driver high up behind the wheel, leaning back in his seat with his head resting to the side against the window, his eyes closed and his mouth slack.
‘We don’t know anything about him. He’s not a regular.’
I open the passenger door and climb up into the cab. Before I even touch him I know he’s arrested. I brace myself between the steering wheel and the chair, give him a thump in the centre of his chest, and start compressions as best I can in that position. He’s a heavy man, probably twenty something stone. The cab is about six feet off the ground. The man who brought me here is looking in through the passenger door.
‘We’re going to need you and a couple of your mates to get him down onto the ground. Quick as you like.’
But Rae is here now and a couple of other centre workers have come out by themselves. Rae tells them to grab hold when I open the door. I pull the latch, the driver sinks out head first into the open air and is handed down in a lurching descent to the ground. The workers step aside. I get back on his chest.
‘Anybody know anything about him?’
‘He’s from up North.’
‘How long do you think he was like this?’
‘Fifteen, maybe twenty minutes. Not much longer.’
A second ambulance arrives.
We follow the protocol, but get nothing.
I check the man’s pockets. A handful of coins, some keys. I ask one of the garden centre workers to look for ID in the cab. He comes back with a wallet and a mobile phone. I read out the man’s name from his driving licence.

We can’t do any more here, but the patient is still well perfused.
We scoop him onto our stretcher and run him off to hospital.

There is a crash team waiting for us in resus. I call out the story as we slide him from our trolley onto theirs.

When the team are well into their run, I leave the room to go and book the patient in and start on the paperwork. I’m half way through when one of the crash nurses comes out to me.
‘They’ve called it,’ she says. ‘Someone has to ring the family.’
And she taps his mobile phone gently, absently, in the palm of her opened hand.