Breathe

by Cari Hunter

  Chapter Four

  The skin on the woman’s arms chronicled her advanced years and poor state of health. The surface was rippled into dehydrated ridges, and it was covered in old bruising and white scars marking previous falls or careless nudges against sharp-edged furniture. She mumbled something nonsensical as Jem tightened a tourniquet around her arm, but she made no attempt to pull away or otherwise acknowledge what Jem was doing. Jem shrugged out of her fleece and used a paper towel to wipe the sweat from her own forehead; the small bedroom was stifling, its air thick with the smell of incontinence and poor personal hygiene.

  “Sharp scratch here, Dorothy.” She gave the warning more out of habit than any expectation of a reply. The vein blew the instant the cannula pierced it, and she swore beneath her breath, pressing gauze over the rapidly spreading bruise. “It’s always the ones who bloody need it,” she said, ripping tape with her teeth whilst contemplating her next target.

  Two courses of antibiotics hadn’t touched Dorothy’s urinary tract infection, and the carers at her residential home had taken a few hours to realise that her violent shivers were due to a high temperature and that the extra blankets they’d piled on her weren’t actually helping. She was septic, her blood pressure low, her pulse and respiratory rate sky-high. She needed time-critical transfer to A&E for IV antibiotics, blood cultures, and fluid resuscitation. Instead, with ambulances queuing in hospital corridors and a stack of 999 calls still waiting for vehicles, Jem was managing alone with a single tank of oxygen and IV saline that she couldn’t find a vein for.

  For the most part, Jem didn’t mind shifts on the rapid response vehicle. The single-manned cars had been introduced to hit government targets designed to get the sickest patients an ambulance within seven minutes. They stopped the clock and ensured essential aid could be rendered, but they couldn’t transport a critically ill patient to the hospital. Jem usually enjoyed the challenge of solo working, and with no regular mate on her line, the RRV could be a welcome break from an ever-changing parade of newbies and numpties. On nights like this, however, when the service was operating at DEFCON 6, the RRV became a nightmare, trapping her on scene for hours without backup, no matter how unstable the patient. At least there were no relatives breathing down her neck this time, just three well-meaning but harried staff members who had a full house of demented residents demanding their attention and who had been only too happy to entrust one of them to her care.

  “Sorry about this, love.” She swabbed a fresh patch of Dorothy’s arm and downgraded the size of her cannula, guided by the logic that any access was better than no access. It was a sound theory, and relief made her feel giddy as she flushed the line and taped it into place. “There we go. All done.”

  Using the door and a coat hanger as a drip stand, she set the saline running wide open and hit the voice button on her radio for the third time.

  “Do I have an ETA on a crew?”

  “That’s a negative, Jem.” Ryan, her usual dispatcher, sounded as despondent as she felt. “We still have thirty-four calls in the stack.”

  “Not your fault, pal. Just do your best, eh?”

  A tentative knock interrupted his reply. She hurried to the door, grabbing the IV to prevent it pulling loose.

  “We contacted her son, but he’s at an office party so he’s not coming over,” the carer said. “He’ll call in the morning to see how she is.” The grim look Jem gave her must have been answer enough, because she sighed and ran a hand through Dorothy’s patchy hair. “She has a ‘Do Not Attempt Resuscitation’ form. I’ll get it out of her file for you.”

  “That’d be really helpful, thanks,” Jem said. Under no illusions as to the outcome of the job, she had positioned the defib in readiness at Dorothy’s side, but the DNAR removed the prospect of having to manage a cardiac arrest on her own if Dorothy finally succumbed.

  “Can I get you a brew, love?” the carer asked.

  “Maybe something cold?” Jem said. “Water or juice? If it’s no bother.”

  “None at all. I’ll see if I can find you a few biccies.”

  Jem’s mouth watered at the prospect of food. It seemed as if days had passed since the cake she’d shared with Ferg in the Abbey Vale cafe. She rechecked Dorothy’s observations, patted each of her pockets until she found her reading glasses, and made a start on her paperwork.

  Eighty-three minutes, two custard creams, and a glass of apple juice later, the roar of a Merc’s engine and the sound of boots on the gravel drive stopped her worrying about her depleted oxygen supply and the saline she was about to run out of.

  “Hey, Spence,” she said as the paramedic poked his head around the door. “It’s good to see you.”

  “Likewise. Been here a while?” he asked, taking stock of the empty IV bags and raising an eyebrow at the blood pressure reading on the defib.

  “Couple of hours. That BP’s the best I’ve had.”

  “Crikey. We’d better get a wriggle on, for what it’s worth. The hospitals are slammed. We’ve just done three hours on the corridor at West Penn.”

  “Joyful.” She helped him and his mate slide Dorothy onto the stretcher. “Let’s hope my next one’s a bag of shite I can flirt off to a doctor, or I’ll be stuck with them till the end of my shift.”

  She walked down to the ambulance with the crew, handing Dorothy’s details over as they steered the stretcher through the maze of corridors, and swapping oxygen cylinders and saline at the vehicle. Spence smiled at her as she stowed the tail lift for him.

  “I’d wish you good luck, but I’d be wasting my breath,” he said, and laughed when she punched his arm. He’d spent six months working on a temporary line with her before he’d transferred to the Hazardous Area Response Team, which was five months more than anyone else had managed. “Take it easy, Jem.”

  “Yeah, you too.”

  The EMT hit the blues at the gate, the strobes illuminating sporadic spots of rain that had become a fully-fledged downpour by the time Jem reached the RRV. She stopped in the middle of the driveway and turned her face skyward, relishing the coolness against her heated cheeks and letting the droplets rinse the smell of Dorothy’s room from her hair. Feeling less desperate to go back to station for a shower, she stowed her kit and settled into the driver’s seat. Ryan reacted to her “clear on scene” message within seconds, simultaneously sending her a job and voicing her on the radio.

  “We’ve got nothing else for this one,” he told her, as she scrolled through the inputted information. “Are you okay to assess or would you rather wait for backup?”

  “I’m okay to assess,” she replied, pulling out of the car park and accelerating on the main road. “Are the police running?”

  “Notified, but nothing available. Update us from scene.”

  “Wilco.” She released the radio’s lever, glancing again at the job’s description. Male. Approx 17 yoa. Unconscious with multiple injuries. Caller to meet crew on Ellery Lane.

  “Shit,” she said, her sweaty palms slippery against the steering wheel. The address had been given as Abbey Vale Nature Reserve, with an almost apologetic addendum, River near the lake, which didn’t really narrow it down. There were three lakes, interconnected by numerous rivers and streams, and Ellery Lane tapered out well short of them. For all she knew, the caller was the patient’s assailant, and she had just agreed to follow him into the middle of nowhere.

  Slowing for a red light, she hit the sirens and then crept through the junction, checking each lane was clear of traffic. She would be off the main roads in less than a mile, weaving through the back streets until she finally joined Ellery, a rutted, unlit track that few visitors used for access. She dried her left hand on her trousers and hovered over the talk request button, getting as far as putting her thumb on it but without exerting any pressure. What the hell would she say? “I’ve had a bit of a think and I’ve changed my mind. I’d rather sit on my arse at a rendezvous point and leave the lad to freeze or bleed to death”? She was no
martyr, eager to rush headlong into danger for glory’s sake, but she had an emergency button on her radio, a hefty torch, a waterproof jacket, and—thanks to an almost magnetic attraction for this kind of job—ample experience.

  “Once more unto the breach,” she said, and took a left onto Ellery Lane.

  Any hopes of the call being a hoax disintegrated the instant she saw the man waving at her, a frantic two-armed windmill impersonation that had “bad job” written all over it. As she threw on her high-vis jacket, he ran to her car.

  “Where’s the ambulance?” he said, peering beyond her into the darkness.

  “I’m it.” She passed him her torch and yanked the boot open, collecting as much equipment as they could carry between them. “Grab this. And this. Sling that on your shoulder, it’s easier.” She studied him as she spoke. He looked familiar, although she couldn’t place his face.

  “You’re the little dog lady,” he said, neatly solving the head-scratcher as she slammed the boot shut. He dropped one of the bags she’d given him and snatched it up again before it could topple into a puddle. “From earlier in the Vale. I was with my mate.”

  “Ah, that’s right,” she said, realising he was one of the homeless lads and feeling marginally safer. He’d seemed harmless that afternoon and still seemed harmless now, his expression tight with fear and worry. A smell of damp earth and stale beer rolled off him, but his clumsiness was probably due to nerves rather than intoxication.

  They set off together, skirting potholes and puddles as they left the lane and entered the wood, the torchlight bouncing around to pick out tall pines and deciduous trees still barren after winter.

  “How far?” she asked, already out of puff beneath her burden and struggling to match his pace.

  “Dunno, miss. A mile or so? It’s hard to say.”

  “Okay.” She tried to distinguish landmarks, anything she could use to describe the route and guide people in, but all she saw was the forest looming above her and the quagmire coating the ground. If there was a path, it had long ago been hidden by leaf litter. Twenty minutes later, with no sign of them closing in on their destination, she voiced Ryan and requested he mobilise Mountain Rescue, though she had no idea where to send them.

  “Get them to Ellery, at least,” she said, attempting to keep the strain from her voice. “I’ll send someone back for them.” Her feet slid sideways, and she lost her grip on her radio, Ryan’s affirmative muffled by the mud.

  The man stooped and retrieved it for her. “Not far now,” he told her.

  “Cheers. What’s your name? I’m Jem.”

  “Brian, but I go by Bear.” He touched the bristles of his thick beard and used the same two fingers to give a high-pitched whistle. At the answering yell, he altered his course slightly, and she heard the swift rush of water seconds before her torch picked out his companion crouching at the side of the river. Finding a burst of energy from somewhere, she sprinted toward the second man, and dropped her bags by the young lad he was attempting to shield from the worst of the rain. He’d used one of their sleeping bags to rig a shelter in some low branches and the other to cover the lad, but the wind was whipping across the nearby lake, driving rain in from all angles, and the river was swollen enough to have edged beyond the confines of its banks, saturating the ground she knelt on.

  “Hey,” she said. “How’s he doing?”

  “He stopped moaning,” the man whispered, the words choked and distraught. “He were moaning at first, but he couldn’t say owt.”

  She lifted the sleeping bag and trained her torch on the lad’s face. He was younger than she’d expected, fifteen at most, scrawny and deathly pale, the visible parts of his body marred by bruises and lacerations. Twigs and strands of vegetation were tangled in his hair, and the rich smell of copper mingled with that of churned-up muck.

  “Was he in the water?” She unzipped her response bag, her mind a whirl as she tried to order and prioritise her actions.

  “Yeah, caught up on that tree.” Bear pointed at a stooped trunk, its branches skimming the river’s surface. “We couldn’t leave him in there.”

  “You did fine.” She fastened a hard collar around the lad’s neck and secured an oxygen mask. On the monitor, his heart rate was sluggish and irregular at forty, and a flick of her pen-torch showed a blown left pupil. When she pulled her gloved hands from the back of his head, they were covered in fresh blood and small lumps of spongy tissue.

  “Shit,” she said, her heart sinking. She took off her high-vis and spread it on less sodden ground. “Help me lift him onto this. Gently, good, that’s great.”

  The men handled the lad as if he were made of bone china, hovering close by once they’d repositioned him but evidently floundering without direct instruction.

  “Can one of you go back to Ellery?” she asked, using her fleece to dry the lad’s chest so she could attach the defib pads. “Wait for Mountain Rescue or whoever gets there first, and show them where we are.”

  “I’ll go,” Bear’s mate said. He looked green around the gills, and when she nodded at him he scarpered as if afraid she might change her mind.

  The crash of his footsteps was still audible when the lad’s respiration rate abruptly dropped and his pulse took a similar nosedive. Jem positioned the ventilation bag and used it to support his faltering breaths.

  “I need help out here,” she shouted into her radio, too stressed to go through the proper channels. “This lad’s about to arrest and I can’t move him on my own.”

  “Police are en route,” Ryan said. “No ETA.”

  “Thank fuck for that,” she muttered. Then, louder, “Cheers. Better than nothing.” She let the radio go, reaching for the suction as the lad gagged and coughed, the bag and mask falling aside to allow a thick spray of blood and vomit to splatter across her shirt. His hands flew up without warning, ragged nails clawing at her arms and clothing.

  “Shh, it’s all right,” she said, fighting to keep him still. “You’re all right. I’m a paramedic. No one’s going to hurt you.”

  A thin wail sent goose pimples rippling across her skin, and for an irrational moment she thought he might wake, until the noise cut off as if a switch had been hit, his hands falling limp, his body tensing and then relaxing. She watched, horrified, as eight breaths became five, then two, then stopped altogether.

  “Shit.” She looked at the monitor, its screen now showing an irregular mess of rapid spikes. “Bear, move! Get clear.”

  She hit charge on the defib as Bear stared, open-mouthed. The shock she administered made the lad’s limbs jerk in unison and turned the spikes into an ominous flat line. She immediately started CPR, counting out the rate as she pushed on his bony chest, and wincing at the flex and crack of a rib beneath the heel of her hand. Thirty compressions to two breaths: she repeated the cycle without pause, willing the monitor to show even the slightest sign of recovery, but there was nothing except the beat she created, the line falling flat every time she stopped to give a breath. Time passed by in a blur of pumping first his chest and then the bag, as the rain continued to pour and further bursts of river water washed toward them. The exertion stopped her from feeling the cold, but she could feel the muscles in her arms beginning to shake, and she knew she had to rest.

  “Bear, can you help me? Here, like this.” She positioned his hands and started the metronome on the monitor. “This’ll keep you to a rhythm. Don’t push too hard. That’s perfect.”

  Holding the torch in her mouth, she dragged her bag closer and found the IV pouch. Hypothermia ruled out a peripheral line, so she tried for the external jugular, letting out a short gasp of surprise when she hit it first time.

  “Adrenaline’s in,” she said, marking the time on her glove.

  Bear nodded as if he understood and then cocked his head to one side, his compressions faltering. “I can hear someone shouting,” he said. “Should I go and fetch them?”

  “Yes, go. I’ve got this.” She readied her hands again, sw
apping roles smoothly as he scrambled to his feet.

  “Won’t be long, miss.”

  He quickly vanished from sight, swallowed up by the fog swirling off the lake. The metronome continued to tick, its measured beat a stark contrast to the frantic pounding of her pulse. Thirty to two, thirty to two, over and over, even though she knew it was hopeless, that it had already been too long and nothing she could do for the lad would fix him. Thirty to two. Thirty to two. Biting down on her lip, she bowed her head and persevered.

  * * *

  The snap and crunch of twigs sounded like firecrackers, sharp little explosions approaching at speed. Already twitchy after her half-mile trek through the woods with Grizzly Adams’s less kempt brother for an escort, Rosie stopped dead and saw Kash reach for his Taser.

  “The fuck?” he whispered. “Can you hear that?”

  “Of course I can. You watch too many bloody horror films,” she said, but then put her hand on her own Taser as she saw a large bearded man sprinting toward them. He stopped a couple of metres in front of them, his feet skidding in the wet leaves.

  “This way,” he said. “Come on, come on. Mickey, you go back to the road and wait for the rest of ’em.”

  Spurred by his urgency, they followed their new guide without question, hurdling fallen trees and splashing through boggy patches of grass. Mist rose and fell as they ran, and from a distance Rosie spotted a small, huddled figure, arms outstretched and tight as bowstrings as they pressed down repeatedly on a body.

  “Shit. We’ll need Major Crimes and SOCO here ASAP,” she said. They hadn’t been told much about the job, just that it was an injured male in the woods, with a medic requesting assistance. There had been no further updates en route, so no one had warned them about blundering into a possible crime scene.