Man Down

by Nathan Burrows

  ‘Very good, mate,’ Ronald said as they both hopped out of the Land Rover. ‘You’re getting better every day.’

  ‘Oh piss off, Ronald,’ Lizzie replied with a smile. ‘Now move. Ladies first.’ She pushed in front of Ronald and into the tent, sighing with relief as the cold air-conditioned air washed over her.

  ‘Oh for God’s sake, they’ve not even made the bloody tea!’ Lizzie exclaimed. ‘Mind you, after last time, it’s probably just as well.’

  ‘Their kit’s not here either,’ Ronald said. ‘They must still be down in the Emergency Room. Shall we go down there and give them grief?’

  ‘Sounds like a plan to me,’ Lizzie replied, flicking the switch on the kettle as she walked past it.

  As they walked down the dark corridor in the central spine of the hospital, Lizzie was almost pushed into the wall by a nurse running out of the intensive care unit and down towards the Emergency Room. Lizzie was about to shout something at his back when she heard raised voices coming from the flaps that led to the Emergency Room. Followed by Ronald, she pushed past the same flaps that the nurse had just burst through.

  Inside the normally quiet and controlled department was a scene of hurried activity as the medical team worked on the casualty on the trolley. A medic was astride the patient, administering cardiac compressions, while other members of the team rushed around the equipment. To her horror, Lizzie realised that the casualty on the trolley was the one that they had just delivered to the hospital.

  Adams looked down at the lifeless body of Perry on the trolley, whose arms were jerking with each cardiac compression.

  ‘You okay?’ he asked Corporal Wardle who was standing right next to him. Almost too close. ‘They’re about to call it anyway. I’m just going over there to talk to my oppos.’ Corporal Wardle nodded, her eyes teary, and Adams walked across the room to join Lizzie and Ronald.

  ‘He went off a couple of minutes after we got him in here,’ Adams said to them both. ‘Sat bolt upright, started shouting, then bang. He was in VF. We must have been working on him for fifteen or twenty minutes, and he’s not responded to anything. He’s been in asystole for a while now, so I reckon that they’re about to call it.’ Adams nodded towards Squadron Leader Webb, Major Clarke, and the anaesthetist, who were huddled deep in conversation a few feet away from the trolley.

  Squadron Leader Webb turned away from the group and spoke to everyone in the room.

  ‘Right, Ladies and Gents. He’s been in asystole for nearly fifteen minutes, not responded to anything. Unless anyone disagrees, we’re calling it.’ Adams watched as the Squadron Leader looked around the room. No one said a word. Webb looked at his watch. ‘Time of death, 14.21.’

  Adams tapped Lizzie on the forearm.

  ‘Lizzie,’ he said. She didn’t respond but was just staring at the casualty. He tapped her arm again. ‘Lizzie?’

  ‘Sorry, yep?’ she replied.

  ‘Can you keep a close eye on Corporal Wardle, mate. She’s really shaky.’ They both looked across at Emma, who looked as if she was just about to burst into tears.

  ‘Of course,’ Lizzie said. ‘Of course I will.’ Adams walked back across the room and collected his equipment, returning to where Lizzie and Ronald were standing. Colonel Nick was a few feet behind him, with his equipment already in his hands. Adams walked through the doors of the Emergency Room, followed by the rest of the team.

  As they walked into the TRT tent, Adams put his kit on the floor and sat down in one of the green canvas chairs with a thud. Colonel Nick put his kit down next to Adams's and went to the kettle to make the tea.

  Adams waited until everyone was sitting down and the Colonel had done the business with the kettle and watched as Lizzie took a tentative sip of her tea. On any other day, the grimace on her face as she tasted it would have been funny. ‘We were always going to lose one sooner or later,’ he said to the group in general. ‘And we did get him to the Emergency Room. He was alive when we got him in.’

  ‘That doesn’t make a blind bit of fucking difference!’ Ronald exclaimed.

  ‘Ronald,’ Adams said, noticing Lizzie flinch at Ronald’s words.

  ‘Sorry, sir, but he’s still fucking dead.’

  ‘Got that, Corporal MacDonald,’ Adams said, sharply. ‘Thank you.’ Adams didn’t use rank that often for his subordinates, and when he did, it was a clear message that one of them was talking out of turn. Adams fixed Ronald with a stare before turning to Colonel Nick.

  ‘What do you think happened then? He just went off in the space of a couple of seconds.’

  ‘Young, fit bloke. No co-morbidity,’ Colonel Nick replied. ‘People like him can compensate for quite a lot longer than you think. Then the body just gets to a point and gives up.’

  ‘I guess,’ Adams replied. ‘But I thought he was doing okay.’

  ‘He was stable in the helicopter,’ Lizzie chipped in. ‘I mean, yeah, horrendous injuries. But that is a shock.’ She reached across and squeezed Ronald’s knee. Adams caught the sympathetic expression on Lizzie’s face as she looked at Ronald, and he loved her for it.

  ‘I don’t get the hypertension, though,’ Adams said.

  ‘What, when?’ Ronald asked.

  ‘Just before he arrested, his blood pressure went through the roof. I thought it was the cuff at first, he was wriggling around a fair bit, but it wasn’t that,’ Adams said. ‘Then a few seconds later he went into VF after a run of ectopics. One of them must have hit the T wave.’ Seeing the surprised expression on Colonel Nick’s face as he said this, he added, ‘I’ve seen it before. We had a motorcyclist back in Birmingham who’d come second in a fight with a lorry. Smashed himself right up, internal bleeding, the works. He had a run of ectopics, and then went straight into VF. I was talking to Professor Middlebrook about it afterwards and he was explaining it.’

  ‘Oh, right,’ Colonel Nick said. ‘Middlebrook’s a good bloke. He was my mentor when I was doing my emergency medicine rotation.’

  ‘Mind you,’ Adams continued, not wanting the Colonel to go off down a rabbit hole, ‘we shocked the motorcyclist straight back out of it, and he went to theatre. I can’t remember what they found, but they patched him up okay in the end.’

  ‘Our chap had the full protocol,’ Colonel Nick said. ‘There was nothing else that could be done.’

  Adams stood up, stretched, and walked across to the sink to wash up his cup. As he emptied the rancid tea down the sink, he tried to do it quietly so that Colonel Nick wouldn’t notice. It probably wasn’t the time to take the piss out of him about his poor skills in the tea making department. Adams turned to the others.

  ‘Right, Ronald?’ Ronald turned and looked at Adams. ‘Can you throw the kit into the back of the wagon? I’ll come down to stores with you to do the re-stock.’ Without a word, Ronald picked up the bags and walked out of the rear doors of the TRT tent.

  ‘Is he okay, do you think?’ Lizzie asked Adams.

  ‘He’ll be fine,’ Adams replied. He’d been surprised by Ronald’s outburst as he was normally by far the most placid member of the team and he didn’t think he’d ever heard him swear before. Adams wanted to have a quiet chat with him, and during the re-stock would be a good opportunity.

  ‘I’m going to grab a quick shower,’ Colonel Nick said, getting to his feet and heading towards the door. Adams knew he needed one as well, but figured he could have one later.

  ‘Sir?’ Adams called out to the Colonel. ‘Shall we all meet back here in half an hour? We can go down to the coffee shop and do the formal debrief there.’

  ‘Sounds like a plan to me,’ the Colonel replied as he left the tent. ‘I’ll see you both then.’

  When it was just the two of them in the TRT tent, Adams crossed to where Lizzie was sitting.

  ‘Well, that was all a bit shit,’ he said, looking at her. Lizzie glanced up at him and he could see tears pricking the corners of her eyes.

  ‘Don’t say anything else,’ she replied in a quiet voice. �
��Not about what happened back there.’ She nodded in the direction of the ER and a fat tear escaped, rolling its way down her cheek.

  ‘It’s okay to be upset, Lizzie,’ Adams said. ‘It’s what makes you human.’

  Lizzie put her hands over her face, and her shoulders heaved.

  ‘It’s not fair, Adams,’ she replied through the sobs. He leaned over and pulled her into a tight hug. They sat in silence for a few moments, perched awkwardly on the canvas chairs.

  ‘I stink,’ Lizzie said, pulling her hands away from her face and wiping her nose with a crumpled tissue.

  ‘I know,’ Adams replied. ‘You smell like a male changing room after football.’

  ‘Oh, thanks,’ she said with a wry grin. ‘You’re not any better yourself.’

  ‘Maybe you should go and find Emma and make sure that she’s okay. I know Major Clarke is around somewhere, but he’ll probably be too busy trying to catch a sneaky look down her scrubs to be that sympathetic. She might need a shoulder to cry on?’

  ‘Don’t we all,’ Lizzie replied with a grateful smile at Adams. ‘Don’t we all.’

  15

  Well, that had gone a lot better than he was expecting. He was sitting in the toilets, which was the only place in the entire hospital where he could get some proper privacy. It was fitting, he thought, to be sitting here in the same place as he had prepared his tools for the job. The job that was now finished. It had gone perfectly as far as he was concerned. The switch of the ampoule had been seamless, the timing had been just right when everyone was focused on moving the casualty. And now all the evidence was safely hidden in a clinical sharps bin which would be incinerated within a couple of days. No one would be looking in there, even if they knew that a crime had taken place. One of the few advantages of being in this God forsaken place was that the last thing anyone wanted was bags of clinical waste hanging around in the heat. They got incinerated in a far corner of the compound where the stench from the smoke wouldn’t drift back over the base, and as far as he knew, the bags were burnt every night. Grinning in the cubicle, he allowed himself a few moments to reflect on his achievement. There had been some talk a few days ago about installing video cameras in the Emergency Room bays so that they could replay trauma calls, supposedly to learn from them. That would be one video he would watch over and over again if he had the chance. It was a shame that nothing had come of the conversation. When the military could barely afford bullets, the last thing they were going to spend any money on was video cameras for a hospital.

  He thought back to the nurse who’d killed the soldier on his behalf. Corporal Emma Wardle. Blonde hair, an innocent looking face like butter wouldn’t melt. A tiny nose with a dusting of freckles and full lips made for a lot more than just talking. She was beautiful, and she’d killed for him. He felt himself growing harder as he thought about her. He wondered what her sex face looked like. Would she be noisy, or would she moan softly? He shifted on the toilet seat to relieve the discomfort in his trousers, thinking about and dismissing straight away the idea of relieving himself properly in the toilet. He’d go to his usual spot later, he thought. There were a couple of Portaloos around the back of the hospital that were rarely used and were in an area where no-one went, especially at night as it was pitch black. He’d go there this evening and relieve that particular pressure. But he knew who he’d be thinking about.

  When the soldier sat up and started shouting, he’d jumped along with most of the other people in the Emergency Room. He’d not been expecting that, nor had he expected the soldier to arrest so quickly. He’d done plenty of homework into the effects of adrenaline overdose and knew that it would be quick to take effect, but he’d not expected it to be almost immediate. He didn’t even know if it would actually kill the casualty or not, although he thought it probably would. Well, he knew the answer to that one now.

  There would be a post-mortem of course. The dead soldier would be boxed up and shipped home before being paraded through the streets wrapped in a red, white, and blue union flag. But he wasn’t worried about a post-mortem. He was sure that the fact the soldier’s leg had been hanging off would be enough for the coroner. That was why he didn’t use the ampoule on the earlier casualty. He was badly injured, but it was only a chest wound. Very survivable. If he’d killed him, it might be more obvious that he’d been murdered. But even then, it would take an eagle-eyed pathologist to notice. He got to his feet and flushed the toilet, grinning again as he opened the cubicle door before walking to the sink to wash his hands even though he’d not actually used the toilet. Just in case anyone came in.

  He wasn’t even worried about a toxicology screen. What was the first drug that was used in a cardiac arrest? Adrenaline. The soldier would be full of it.

  16

  Emma Wardle was trying really hard not to start crying in the Emergency Room. She was working with Major Clarke to get Perry’s body ready to be taken to the morgue and struggling to keep her emotions in check.

  ‘Emma,’ Major Clarke said in a soft voice. ‘I can get someone else to give me a hand with this if you want?’

  ‘No, thanks, sir,’ Emma replied. ‘I’ll be fine. I want to do it.’ She didn’t want to be treated with kid gloves. Even though she knew that the Major was doing what he thought was the right thing to do, Emma didn’t want to be treated any differently just because she was a woman. She was fairly sure that he wouldn’t talk to a male nurse that way.

  ‘Okay, only if you’re sure though. I’ll go and get the body bag, and a couple of med techs to help us roll him.’ Major Clarke wandered out into the store at the back of the Emergency Room, leaving Emma to her thoughts.

  Alone with Perry, Emma looked down at his face and stroked his cheek with her gloved hand.

  ‘You poor bastard,’ she murmured. He was so young, she thought. She’d never met him before, but she felt a strong connection with the dead soldier. She’d noticed a similar thing before, but with older people who’d died. Never with someone who was a similar age to herself. Emma wondered if he had any brothers or sisters, or a girlfriend. His family, his loved ones, were going to be devastated when they found out what had happened to him.

  Clarke walked back into the room carrying a thick rubber black body bag, followed by a couple of sheepish-looking medical technicians. They clearly didn’t want to be there, but Clarke was a Major and they were both junior ranks so that was that.

  ‘Right,’ Clarke said. ‘Corporal Wardle, can you make sure that all the various medical bits and pieces are properly secured? They’ll need to be in the same place when he gets back home.’

  Pleased to have something to do, Emma picked up some surgical tape from the trolley next to her and started taping down the cannula in Perry’s left arm. Clarke unrolled the body bag next to Perry’s body and started to give instructions to the others how to roll him into the bag.

  ‘On three, roll him onto his side towards you. I’ll tuck half of the bag under him, then roll him back. Then he goes over the other way so you two come around this side for that bit. Right?’ Both the medical technicians nodded. Emma was used to this manoeuvre as a nurse, but she figured that Clarke was just making sure that the med techs knew what to do. This probably wasn’t something they’d ever done before.

  ‘One, two, three,’ Clarke counted. The team rolled Perry onto his side, and Clarke did exactly what he said he was going to do. After the second part of the roll, Perry was lying on top of the body bag. Clarke and Emma untucked the rolls of the bag and put Perry’s arms across his chest, doing up the industrial zipper on the bag as far as Perry’s neck.

  ‘Hold on a second, sir,’ Emma said. Clarke stopped what he was doing and let go of the zip. Emma looked across at Clarke and said, ‘Thanks.’ She looked down at Perry’s eyes, now closed with a strip of surgical tape across them. Looking up at Clarke, she said ‘Can I…?’

  ‘Of course, you can,’ he replied.

  Emma reached out her hand and took the zip in her fingers. She
gently closed the body bag over Perry’s face.

  Adams walked into the equipment store and dumped the medical bags onto a counter. He crossed his arms and turned to Ronald.

  ‘Right, mate. We’ve got half an hour. Let’s get these squared away as soon as we can. But we do need a little chat first, I think.’

  ‘Yep, okay,’ Ronald said, looking nervous. Adams knew that Ronald knew what was coming, but it wasn’t going to make any difference to the conversation. ‘Er Adams, about what I said back in the tent, I–’

  ‘Just wait a second and listen in,’ Adams cut him off, staring at Ronald until he nodded in agreement. ‘What you said back there was bang out of order. I’ve just left Sergeant Jarman in tears over the whole sorry incident, and you bumping your gums like that doesn’t help.’

  ‘I know, but–’

  ‘McDonald, zip it. I’m talking, you’re listening.’ Adams waited for a few seconds before continuing. ‘Now we’re a team, all four of us. That means we work together as a team, and sniping at each other isn’t how we work. If you need to let off steam, then you wait until it’s just you and me, or you and Lizzie if that works better for you. But when we’re together, then you stay professional at all times. Do you understand?’

  ‘Yes, sir,’ Ronald replied with a baleful look. Adams pointed at a chair. ‘Sit down, mate, and consider yourself bollocked. I’ve done my officer bit. Now, do you want to talk about what happened? As Adams and Ronald?’

  ‘Not really, sir.’ Adams gave Ronald a reproachful look.

  ‘Ronald, I’ve told you before. If I’m not bollocking you and it’s just us around, then it’s Adams. Every time you call me sir it makes me feel old.’

  ‘Okay, got it.’

  ‘But if you do want to chat, as mates, then you know where I am.’ Ronald nodded and picked up one of the medical bags.