John rubbed his eyes. He’d been on call for forty-eight hours and spent nearly all of it with baby Jones in the Special Care Unit. Roxanne, the young mum, smiled wearily as he left. ‘We’re going to call him John, after you. Thank you for saving his life.’ She hugged him tight.
He hadn’t, but was too tired to argue. He looked at Roxanne and Jason holding hands over their son’s cot.
‘He looks so perfect,’ said Jason. He bit his lip and asked again, ‘He’ll be alright, won’t he?’
John pulled up a chair so he wasn’t looking down at the young couple; they made him feel old. He tried to explain. ‘Sometimes there’s an obvious reason why babies don’t do well, but sometimes we never find out. I can’t say exactly what’s wrong with your baby, but it’s early days. We’ll do the best we can for him.’
‘Do you think he’ll be okay?’ Roxanne begged for the magical yes.
‘I don’t know until we have a proper diagnosis, but he’s a little fighter.’
Roxanne’s mother Dawn arrived. ‘Oh Roxy, congratulations. My first grandson. Why is he here on the Special Care Unit?’
‘There’s something wrong with him, Mam.’
Dawn peered into his cot. ‘What’s wrong with him? He looks perfect. Why’s he got all those wires?’
‘They don’t know yet.’ Roxanne glanced at John. ‘He won’t breathe properly.’
Dawn straightened up, facing John squarely. Her eyes narrowed. ‘Are you the baby doctor?’
‘I’m looking after your grandson, yes.’
‘So what’s wrong with him?’
‘We’re doing tests.’
John’s bleeper went. ‘I’m sorry, I have to go. I’ll catch up with you two later.’
After he’d re-sited the intravenous infusion in Nina Wall on Ward 14, he went back to baby John for a final check before going off duty for the weekend.
Sister Sheila said, ‘I think the baby is doing a little better than a couple of hours ago.’ She smiled at John; she was always optimistic. You couldn’t work on the Special Care Unit if you didn’t believe in miracles.
John watched the baby kick and wave his arms, swinging balled fists against the life he’d been landed with. John sighed and said, ‘He’s still going to need ventilating.’
John went off duty, pulling his tie and undoing his top shirt button as he went. He met Marcus in the corridor. ‘Hey Marcus, are you on call this weekend?’
‘Yeah, unfortunately, I’m getting too old for this lark.’
‘There’s an interesting case on the Special Care Unit. A normal antenatal history with an uneventful delivery, but almost immediately the baby was in trouble. Some slight webbing of hands and feet but most worrying is the respiratory distress; he’s struggling to breathe. There’s no recognisable syndrome that I know of. The anaesthetist is there now ventilating him.’
Marcus yawned. ‘Great, just what I need. Are the parents aware of all this?’
‘I’ve tried to put them in the picture. They’re very young, in shock, I think. I’m not sure they’ve taken in a word I’ve said.’
‘It’s getting better and better.’
‘And be careful with the grandmother; she’s feisty.’
Marcus grimaced. ‘John, why do I get all the luck?’
John patted his shoulder, laughing. ‘You must’ve been wicked in a previous life.’ He waved. ‘Have a good weekend and don’t work too hard.’
Marcus watched John saunter down the corridor whistling quietly. John never seemed to question what they were doing, never got tired of playing God; thumbs up or down to life. Marcus’s head pounded, he was hungover again. He stepped heavily, trudging along the corridor. It seemed uphill, his thighs twitched, he was tired and hungry. The line between making a difference to people’s lives and simply meddling was blurring. Mother Nature was smarter than medicine. Recently, Marcus wanted to pay more respect to this. He was sick of trying to save hopeless cases, condemning some poor kid to a half brain-dead existence.
He headed for the crazy, mixed-up world of Ward 10. In Bed 4 was a petrified Mrs Dawson on bed-rest. It was her third pregnancy; she’d lost the other two at about five months, this time she was at six and a half months gestation. In Bed 5 was Bev, one of their regulars, in for her fourth termination. The two women chatted about morning sickness.
John drove slowly. He was tired and thinking about baby John. The miracle of life never ceased to amaze: warm, soft skin; a beating heart; a new life. Even an imperfect one was exquisite. The baby had fluttered muddy, watery eyes, unfocused. John had stared, holding a fellow human being swimming upstream while he examined him. He was struggling to survive.
Marcus introduced himself to Jason and Roxanne. An older, blonde woman scowled at him. ‘I’m the baby’s grandmother. What’s all this about something wrong with him?’
‘I’m on duty for the weekend and I’ll be looking after baby,’ Marcus said. ‘I’d like to examine him first.’
‘Well, I hope we’ll have some answers soon, that other doctor didn’t tell us anything proper.’
‘Mam, don’t.’ Roxanne looked tearful.
‘We’ve had to give him a bit of extra help with his breathing,’ said Marcus.
‘Why?’ said the grandmother, crossing her arms.
‘Because he’s not managing on his own.’
‘He looks alright to me. If you don’t know what’s wrong with him, how do we know there’s anything wrong with him, eh? I’ve had five kids and he looks right as rain to me.’
Marcus bit the inside of his mouth. ‘Well, he isn’t.’
Baby John was wired up and plumbed in. He’d been given muscle relaxants so he couldn’t thrash and flail. The parents sat either side of the incubator. ‘Will he be alright?’
Marcus focused on the baby. It was easier than looking at their pleading eyes. ‘We don’t know, sometimes this happens. A child totally flummoxes the textbooks and is an unknown quantity.’
John sighed at the traffic lights. In all honesty, he knew the odds were stacked against baby John, but there were exceptions to every rule. It was the million-to-one shot that made this job worthwhile, the ones that against all odds made it. He thought of the flicker of hope in the baby’s smoky eyes, a connection; he looked like a fighter. A car beeped behind, the lights changed; John was exhausted, he needed to concentrate. A weekend away from the hospital would recharge his batteries. He’d switch off, have a nice meal and bottle of wine with Maria. They’d have a lazy lie-in. Maria wanted to shop for a new sofa, he’d see how he felt. He turned into their driveway. He knew he’d ponder over baby John, he hoped for him.
Marcus burped quietly; he had nauseous, post-booze heartburn. He stared at the little body of baby John, his chest going up and down, the map of fine blue veins he could trace under his skin. He felt a hopeless futility creep into his heart. Recently, he felt it often.
Marcus spent a long time with the parents. ‘No one can predict how your baby will do.’ He talked slower. ‘We don’t know exactly what’s wrong with him, but he doesn’t seem able to breathe unaided.’
‘The other doctor seemed to think things were a bit better than you’re saying,’ Roxanne snivelled.
Marcus looked at his shoes. Bloody sunshine John.
John un-clicked the door, the smell of home-baked lasagne and the racket of Danny’s music throbbed through the house. He could see Maria in the kitchen and heard her talking to Steph. ‘You’ve got to be back by midnight or I’ll ground you for a month.’
‘I will, Mum, take a chill pill.’ Steph flounced past John. ‘See you later, Dad.’
He watched her swagger out in a tiny micro skirt. ‘Bye, sweetheart,’ he muttered to the closing door. In the kitchen he kissed Maria. ‘D’you think that skirt’s a bit short for her?’
She patted his hand. ‘Get over it, Daddy.’
Marcus’s bleeper went off all night. He was called out to a difficult twin delivery; one baby lived, the other died. Then he was called out to Mrs Dawson. She was hysterical, she’d started bleeding. The obstetrician had arrived and listened to her belly. He locked eyes with Marcus, giving a small shake of his head.
Marcus blinked and looked at Mrs Dawson. ‘I’m sorry.’ He turned away.
At 6am, he lay down on the small on-call bed. The room was white and bare, the narrow bed unruffled, he’d been up all night. He was so tired. He took a sip of vodka from his inside pocket and closed his eyes. A minute later his bleeper went off. Blank-eyed and bleary, he looked out the window at the clawing morning sunlight. He realised he didn’t look forward to anything in life anymore, except sleep.
The bleep was a call from the Special Care Unit. ‘Baby John’s parents want to speak to you,’ said the nursing sister.
Roxanne and Jason looked exhausted. The randomness of bad luck shot through them. Marcus stood over them, one either side of baby John’s cot. He looked at the little frame inside, the creased skin of the child’s crumpled face; he was an old man in a baby’s body.
‘What’s going to happen?’ asked Jason.
‘We’ll keep monitoring the situation.’ Marcus stifled a yawn.
They had a hollowed, empty look of grief. They were carrying the loss of a perfect newborn baby, and the possible life sentence of caring for a severely handicapped son. They watched their baby, trying to absorb his pain so he wouldn’t suffer. Marcus watched them – the adult of the species trying to always protect their young. In nature, it was survival of the fittest.
Jason pulled his tired eyes away from his son. His voice scratched the air. ‘We don’t want him to suffer.’ He put his finger into the incubator and stroked his son’s slightly deformed fingers. Jason stared at Marcus. ‘I mean, if he needs a ventilator for the rest of his life’ – he shrugged – ‘that’s no life.’ He wiped his eyes with a rough brush of his thumb.
Marcus pulled up a chair. ‘It’s difficult without a diagnosis. We don’t know if he’ll improve or not, it’s not a recognised syndrome.’
‘Christ, doc, he can’t breathe, that’s not compatible with life. What are we trying to do here?’ Jason’s eyes swam with desperation.
Roxanne whispered, ‘We don’t want him to suffer anymore.’
Marcus looked at baby John and away quickly. ‘We could take him off the ventilator and see how he does?’
Marcus knew they were both young, both stupid, they’d do what he suggested. He was so tired, he could maybe get a couple of hours sleep before handover. They both looked back at the ventilated child and nodded.
Baby John died in his parent’s arms peacefully half an hour later. They cradled him together, crooning. All his wires were undone, he was free. They listened to the hush. Roxanne touched his lips with hers, her ear pressed up close to his silence.
John drove in on Monday morning, humming. It had been a good weekend – nothing special, pottered in the garden, had a nice meal and bottle of wine, they’d bought a new sofa, Maria was happy. He parked and whistled his way across the car park. It’d be interesting to see how baby John was doing; he hoped he continued to improve.
He met Marcus on the stairs. ‘Hi Marcus, how was your on-call? You look knackered.’
Marcus shrugged. ‘Not good.’
‘Oh, while I remember’ – John clicked his fingers – ‘are you and Carole still okay for next Saturday night?’
‘Yeah, great.’ Marcus glanced at his feet. He’d have to tell John sometime that Carole had left him three weeks ago, but not now, not yet.
‘How’s baby John? Interesting case, I thought.’
Marcus shook his head. ‘I’m afraid he didn’t make it. The parents requested he be taken off the ventilator.’
John felt a kick in his belly. ‘You took him off? Why the hell? He seemed to be improving.’
‘Come on, John, a slight improvement but his prognosis was awful. We might have eked out another week of agony. As it was, he died at rest with his parents. It’s what they wanted. For once I felt I did a good thing instead of creating misery.’
John fumed, ‘I can’t believe you did that. It’s too early, even a day or two more…’
Marcus yelled, ‘We’re not gods, John. Christ, do you never stop to ask yourself, “What is the point?”’
‘Yes I do,’ John shouted back. ‘We have a responsibility to do our best for our patients. The parents’ decision was emotionally driven; they must’ve been exhausted, not in a position to decide. We still didn’t know what his quality of his life would be, how much he might have improved. His breathing capacity might have increased over the next few days. Christ, Marcus, it was too early… a decision like that…’
Marcus turned and walked away.
He drove back to his own house instead of the rented room he’d existed in since Carole booted him out. He could hardly keep his eyes open, but he did. John’s words echoing round and round his head: quality of life.
He knew Carole would be at her keep fit class. He opened the garage door, drove in, shut it again. He reached up for the hose, hanging on the hook where it always was. He uncoiled it, put one end on the exhaust pipe and one into the driver’s seat. He wound the window back up and made himself comfortable.
It was the only decision he’d been sure of in a long time.