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TESS STARED IN HORROR at the face of the young boy on the trolley. It was clear he was dead.
‘You all right, Doctor? It’s not someone you know is it?’ The paramedic’s voice sounded concerned.
Tess looked at him, trying to stay calm, but struggling. Surrounded by the perpetual noise of Accident and Emergency with the constant flow of trolleys carrying patients of all ages and injuries, the sight of the dead boy had hit her like a physical blow.
‘No, not really. He...he came in last week after a road traffic accident, knocked off his bike by a car. Nothing serious. What...what happened?’
The paramedic, known for his cheerfulness, looked solemn.
‘He was playing in a football match at school and, according to whoever called us, just keeled over as he was about to score.’ He touched the boy’s head. ‘There was nothing we could do, Doctor. Poor kid. But we had to go through the motions, like. Recorded as DOA, I suppose.’ She nodded as he handed her his report.
‘What about the parents?’ She held her breath, knowing she would find it difficult to face them now. What if it was her fault?
‘Away. The lad’s been staying with friends.’ He nodded towards an ashen-faced woman with her arms around a boy wearing the same football kit as Gary. Both looked as if they were about to be sick. Tess called a nurse over and asked her to take them into a private room and give them tea.
‘Thanks, Tom, would you mind taking the...body – Gary – downstairs? I’ll just sign the report and they can carry on from there.’ She dashed her name at the bottom of the report, trying not to look at the pale, unmarked face of the thirteen-year-old boy who had been so chirpy only a week ago. And alive.
‘And what can we do for you, young man?’ It had been a busy day in Accident and Emergency and Tess was looking forward to the end of her shift but she smiled at the boy propped up on the trolley in the cubicle. He looked dazed, with scratches and a bruise on his face. Glancing at the file handed to her by the nurse, she saw his name was Gary Saunders and some speeding driver had knocked him off his bike.
The boy, who reminded her of her brother at that age, was clearly putting on a brave face, but she saw his mouth tighten in pain. His tousled hair stuck up on his scalp and his eyes were wide.
‘My ankle hurts, Doctor, and I was told it had to be checked in case it’s broken. It isn’t is it? Only I’ve a big match coming up next week and I’m the best scorer in the team.’ His look was beseeching as she lifted the blanket.
‘Let’s look, shall we?’ Running her hands over the swollen and bruised ankle she soon realised it was a sprain and told him he needed to rest it, use ice packs and take painkillers.
‘It’s what we call a Grade One sprain and should heal within a week if you’re careful. No cycling or football for the next few days, though. Understood?’
His face lit up.
‘That’s great, thanks, Doctor. Can I have a sick note for school?’
Tess laughed.
‘Hey, I said nothing about missing school! If it hurts to walk on it we can lend you some crutches. I’ll just check the rest of you to make sure we’ve missed nothing.’ Tess knew the paramedics would have examined him, but she wanted nothing left to chance. Better to be safe than sorry, was her mantra.
And now, a week later he was dead. Had she missed something after all?
Later that day Tess sat with her boss, Dr Grant, in his office as he went through the report of Gary’s earlier visit to A & E. It was usual procedure after a sudden death so soon after recent treatment. She sipped water from a plastic cup, willing herself to stay calm and professional. Like anyone in the medical profession, she had always strived to remain emotionally detached from patients, or risk being unable to carry out her work. But haunted by the sight of Gary’s pale, lifeless body, she had almost convinced herself it was her fault. The sick feeling in her stomach tribute to her guilt.
Dr Grant looked up and rubbed his chin.
‘Well, Tess, from what I’ve read here, there seems no connection with what happened a week ago and today’s sad event. You checked all his vital signs, including his heart and pulse, and all was normal. Confirmed by the paramedics who brought him in.’ He sighed, closing the file in front of him, and added, ‘We’ll know for certain after the PM, but I suspect it was an hypertrophic cardiomyopathy, or something similar. It fits the description of how the lad collapsed, without warning. It’s rare, but happens in young men who are otherwise fit, as I’m sure you’re aware.’ His expression was sympathetic and Tess relaxed a little.
‘So, if it was an HCM, for example, I wouldn’t bear any responsibility for Gary’s death?’
‘Absolutely not. Is that what you’ve been worried about?’ His eyes widened. ‘I know it’s an awful thing to happen and it was bad luck you were on duty today when he came in, but please don’t blame yourself. Whatever killed the lad, it wasn’t anything you did or didn’t do. Okay?’
‘Okay, thanks.’ Tess gulped down the last of the water, feeling the knot in her stomach ease.
‘Good. You’re a great doctor, Tess, and I don’t want you worrying yourself unnecessarily.’ Dr Grant stood up and she did the same, keen to leave and go home, suddenly aware of how exhausted she was.
They shook hands and he promised to keep her informed of the results of the post-mortem.
Once out of the office Tess ran to the staff car park, planning to do a quick shop at the supermarket for pizza and wine. She hoped she’d sleep that night with a couple of glasses inside her.
By the time Tess arrived at work the next day she was hungover and a bundle of anxiety. Unfortunately, she hadn’t stopped at two glasses and slept fitfully most of the night. Telling herself ‘never again’, she headed straight for the staff canteen and a double strength latte. Keeping her eyes down she avoided the usual morning chit-chat with her colleagues and pretended to be engrossed in something on her phone. It would be a long day, not only because of her shift, but because the result of the PM wouldn’t be known until late afternoon. No matter Dr Grant’s reassurance, Tess wanted – needed – to know Gary’s death was not her fault. She was nearing the end of her placement in the hospital and wanted to leave without a cloud over her. With an inward groan, Tess swallowed the last of the coffee and headed for A & E and whatever that day would bring.
The regular assortment of road accidents, falls, suspected heart attacks and chest complaints kept her busy and unable to think of anything else and Tess barely had time for a quick sandwich and another strong coffee at lunchtime. Short-staffed, there was no choice but to focus all her energy on dealing with those in pain or afraid. It took her by surprise when she received a message saying Dr Grant wanted to see her. Her watch said it was five fifteen yet she could have sworn it was only about three. After passing on instructions to a junior doctor, Tess made her way once more to Dr Grant’s office, her hands sticky with sweat. Wiping them on her scrubs, she knocked and went in.
‘Ah, Tess, thanks for coming,’ Dr Grant said, with an encouraging smile, from behind his cluttered desk.
‘The PM results are back?’ Her heart was beating so loud she was sure he could hear it.
‘Yes, and it’s as I suspected, HCM. Poor lad.’ He shook his head, frowning. ‘No prior indications and no known family history. But as it’s hereditary I shall insist the family get checked out soon as. I believe there’s a younger brother,’ he said, glancing at the open file, ‘and we don’t want another tragedy in the family, do we?’
Tess felt her own heart slowing down again and shook her head.
‘So, I’m not at fault, sir? I checked his heart as a routine, but...’
‘No, you wouldn’t have picked it up with a stethoscope. You did everything right, Tess, so you have a clear conscience. It was just an unpreventable tragedy.’ He stood and reached to take her hand. ‘The only good thing is we can now monitor the family and prevent it happening again.’
‘Yes, that’s something, I guess. Thank you, sir.’
Once outside the office Tess didn’t know whether to cheer or cry. Cheer for herself as not being responsible for Gary’s death, or cry for the boy lying cold in the mortuary.
By the time Tess arrived back at her flat all she wanted to do was have a quick supper and slouch in front of the television. She knew her boyfriend, Steve, would be unhappy if she didn’t ring and suggest they went out for a drink, but she wasn’t in the mood. As she chewed on her pasta, she wondered if she wanted to see him again at all. She didn’t think he was the proverbial ‘one’, and he hated her working long hours. Tess was still thinking about what to do when her phone rang. Hoping it wasn’t Steve, she picked it up and saw it was her mother. Not much of an improvement as her mother always had something to moan about; she answered warily, ‘Hi, Mum, everything all right?’
‘Depends which way you look at it, Tess. I’m afraid your great-aunt Doris has passed away,’ her mother said, with a deep sigh.
‘Oh, I’m sorry to hear that, Mum. But she was a great age, wasn’t she? In her nineties? And I didn’t think you were close, although I thought she was quite a character.’ Tess hadn’t seen Doris for years, not since her family had left Guernsey and moved to Devon for her father’s job. But she remembered visiting her as a girl and she always had stories to tell and sweets to give.
‘Yes, she was getting on, and at least she died in her sleep, I’m told.’ Her mother sniffed. ‘It’s not her death so much I’m upset about, it’s that according to her advocate, she’s left her house to you and not me.’