double take

Despite Mrs Henty’s thirty-year aversion to doctors, hospitals, medication or intervention of any kind – other than homeopathy – she feels so ill she allows herself to be helped into our chair and carried out to the ambulance. Her daughter is with her, relieved that after two months of these sudden episodes something has changed – serious though it might be – sufficient to force her in to see a doctor. We settle Mrs Henty on the trolley and whizz through our observations.
She has no pain, her oxygen saturations are good, her blood pressure, temperature and so on. But her heart rate is irregular and she looks poorly. When we do a twelve-lead ECG, the result is clear: Mrs Henty is having an anterior MI. We telex the result to the catheter lab, and blue light her in for treatment.
‘Apparently the new protocol is we go to the lab via A&E’ I shout to Frank through the hatch. ‘Last time I went in the old way, but I’m pretty sure I can find it.’

We make it in good time. Mrs Henty’s daughter is a nurse herself – at a different location, but sufficiently au fait with procedure to know what we’re doing and to be useful. She even carries some kit for us as we hurry in through the main A&E doors.
‘Mind your backs! Coming through!’
The department is packed out, as usual, but we bully a passage through to the corridors the other side.
‘Just head for what used to be the medical assessment unit,’ I tell Frank.
But in the six months since I was last there, the department has been reorganised. Partition walls put up, painted and signed for day surgery, a waiting room with lines of pristine blue chairs, posters on walls that used to be open space.
‘Through those doors,’ I tell him.
A porter carrying a rubber mattress is heading in our direction.
‘Is this the right lift for the cardiac catheter lab?’ I ask.
He puts the mattress down on the floor and rests his arm on it.
‘The cath lab?’
‘Uh huh.’
‘Only if it’s an emergency.’
I nod and widen my eyes.
‘Yes, then. Through them doors.’
He picks up the mattress again. But I have a sudden loss of confidence.
‘Can you take us there?’ I ask him.
He puts the mattress down again.
‘To the lifts?’
‘Uh huh.’
He props the mattress against the wall – prodding it a couple of times to make sure it won’t fall – then shuffles ahead of us through the new department. He opens a couple of swing doors, then stands in front of a pair of lifts.
‘Okay?’ he says, sighs, and walks off.
The lift door opens. Inside is an enormous man and woman with an equally inflated toddler in a stroller. In their shiny black PVC puffa jackets they could be a family of gigantic beetles heading out for the day.
‘This isn’t level six,’ he says. The woman frowns.
‘I’m really sorry guys but I’m going to have to ask you to clear the lift. Our patient’s not very well and we need to get her upstairs as quickly as possible. Thanks. Thanks for your help. Sorry. Thanks.’
Reluctantly they leave the elevator. We haul the trolley inside and I push the button to go up.
When the lift opens again we leave quickly and turn left for the lab as we always do.
It’s only then that we realise we’re a floor short, having started from a lower level. But the lift has closed now, so we have to call it again.
A moment later the doors open.
Inside are the family in the puffa jackets.
There’s nothing else to do but brazen it out.
‘Sorry guys. Sorry. I’m going to have to ask you to leave the lift. We’ve got to get our patient upstairs as quickly as possible. Thanks very much. Thanks.’
They shuffle out with a stunned expression and turn to look at us as we pass. As the doors close I see the woman turn to the man, raise a finger to point in our direction and say “Didn’t we just ...?”

We ride the final floor in silence, until Mrs Henty’s daughter shakes her head.
‘I think this is what they call a learning opportunity,’ she says. And then leans forward to read the name on my shirt.