It looked like the back of the drive-in grounds had been used as some sort of dumping ground. Tree branches, decomposing cardboard boxes, plastic piping and general rubbish were strewn over the area.
‘Why do we have to do it now?’ complained Pete.
‘We’ve only got two days left,’ said Marceline. ‘And Ratchet said we could do it before school today. So here we are.’
‘Well,’ said Sally, hands on hips, surveying the area. ‘We better get to it.’
Pete yawned.
But they got to work. There was nothing too large or heavy, so it was reasonably easy. And with the whole class there, it really wasn’t going to take long.
Josh walked over the hard-packed gravel, to the back corner. There was a bunch of boxes piled up next to a low scrubby bush. He grabbed the largest box with both hands and lifted.
Something slithered beneath.
He felt pain flare up in his right leg, as if someone had just whacked him with a stick. Dropping the box he stumbled back with a shout and fell over. He clamped his hand down over the sore bit on his leg.
Pete and Sally came running.
‘What’s wrong?’ asked Pete.
‘What happened?’ asked Sally.
‘I dunno,’ said Josh, voice shaky, confused. ‘Something moved under the box and then I got hit in the leg.’
‘Hit in the leg?’ asked Pete.
Josh shrugged. ‘That’s what it felt like.’
‘Come on,’ said Sally. ‘Better give us a look.’
Josh pulled his hands back to reveal two puncture marks and a smear of blood.
‘Yikes!’ said Pete. ‘Looks like something bit you.’
‘What’s going on?’ demanded Marceline. She was walking over with an annoyed look on her face, as if she thought they were slacking off.
‘Josh has been bitten by something,’ said Sally with a pointed look at Marceline.
‘Oh.’ She seemed a little guilty. Then her expression changed. ‘Oh my gosh, look.’ Marceline was pointing towards the box.
‘What?’ demanded Sally.
‘Something moved!’ shrieked Marceline. ‘I think it was a snake.’
‘Are you sure?’ asked Sally.
‘Yes, I’m sure,’ hissed Marceline. And without another word she turned and ran.
‘Fat lot of good she is,’ complained Pete. Then he looked down at Josh. ‘You okay?’
‘I guess,’ responded Josh. He was staring down at his right leg, wiping away the blood with his hand. There were definitely two marks there, on the left side of his calf. ‘It hurts, but not too badly.’
Some of the other kids, alerted by Marceline’s shout, were now starting to gather around.
Josh put his hands on the ground, ready to push himself up to his feet.
‘No, don’t,’ said Pete urgently. ‘If it is a snakebite, you’re not supposed to move. That spreads the venom.’
‘How do you know?’ demanded Sally.
‘He saw it in a movie,’ Josh chuckled through clenched teeth. The pain was getting worse.
‘Too right.’ Pete nodded proudly.
‘Yeah,’ mocked Sally. ‘’Cause everything in the movies is real.’
Pete shrugged.
‘So then, smartypants,’ continued Sally, ‘if he can’t move, what should we do?’
‘I think you’re supposed to suck the poison out,’ said Pete, with a grimace.
Sally looked horrified. ‘That’s gross!’
‘Well, that’s what they did in the film,’ insisted Pete. ‘Although the guy died in the end.’
‘Oh great,’ said Josh, voice quavering.
‘Don’t move!’ a gravelly voice demanded.
Everyone turned to see Ratchet and Marceline heading towards them. The crowd of onlookers parted and stepped back.
‘This kid reckons you’ve been bit by a snake,’ Ratchet went on, concern evident in her voice. ‘If you have, you don’t want the venom to spread.’
‘See?’ Pete looked pointedly at Sally.
‘Ambulance will be here any minute,’ said Ratchet. ‘The hospital is just a couple of streets away.’
‘Hospital?’ Josh’s voice rose. ‘Ambulance?’
‘Ya never take chances with a snake bite,’ said Ratchet, her voice softening. ‘I called the ambulance as soon as the word snake got said to me.’ She glanced at Marceline. ‘Now, where is it?’
‘Under that box,’ said Marceline, pointing.
Ratchet reached down to her tool belt and chose the largest spanner she had. Brandishing it high, she moved to the box.
Everyone else took a couple of steps away. Josh edged back slowly across the ground, sucking air through his teeth, wincing with the pain, trying not to move his leg too much.
‘We need to get a look at it.’ Ratchet’s voice was a low growl, like an animal getting ready to pounce. ‘Find out what sort of snake it is.’ She gingerly lifted the box.
There was a flash of brown with a cross-hatched pattern sliding across the baked earth and away under the fence.
Marceline screamed.
Ratchet threw the spanner at it. She missed.
‘Pseudechis Australis,’ announced Ratchet. ‘Also known as the King Brown or the Mulga.’ She turned to Josh. ‘You need to get to hospital now!’
‘Should we suck the poison out?’ asked Pete, voice high and panicky. ‘Or tie a tourniquet or something?’
Ratchet looked at him like he was a complete idiot. ‘No!’ she barked. ‘Do you want to kill him?’
Pete shook his head, a shocked expression on his face.
‘The leg needs to be immobilised and bandaged so that the venom doesn’t spread,’ explained Ratchet.
‘How do we do that?’ asked Marceline.
‘We don’t,’ said Ratchet. ‘They do.’ She pointed back to the gates as an ambulance came charging down the street.
The ambulance pulled up close to them and two paramedics raced out, one carrying a black medical bag. All the kids were now standing around, mouths agape.
The man with the bag crouched down beside Josh, as everyone else stood back to give him room. ‘You would be the patient, I assume,’ he said brusquely. ‘Let’s see the wound.’
Josh tentatively let go of his leg, revealing the two puncture marks.
‘Uh-huh,’ muttered the paramedic. ‘Does look like a snakebite. There’s swelling around the marks and they’re still bleeding, indicating coagulopathy.’
‘Coagu-whaty?’ asked Josh meekly.
But the paramedic didn’t hear him. Instead, he raised his voice and asked, ‘Is the snake still around or did anyone get a good look at it.’
‘Snake’s gone,’ said Ratchet. ‘Went under the fence. But it was definitely a King Brown.’
‘You sure?’ asked the paramedic.
‘It was big – at least a metre long, maybe more. Brown colouring, with a tinge of yellow. Crosshatching pattern. I know me snakes. It was Pseudechis Australis.’
‘Riiiight,’ said the paramedic slowly. ‘We’ll need to confirm with a venom detection when we get to the hospital, but we’ll assume for the moment that you’re correct. If it is a King Brown bite and we have definite envenoming, we’ll need to get you to Adelaide.’ He turned to his colleague. ‘Matt, better call in and get the RFDS on standby in case we need them. Then we’ll bandage him up with a splint.’
As Matt went back to the ambulance, the first paramedic returned his attention to Josh. He waved a pen light directly into his eyes. Josh blinked and squinted.
‘Is that uncomfortable?’ asked the paramedic.
‘It’s a bit bright,’ answered Josh.
‘Hmm. Sensitivity to light.’
The paramedic checked his heart and blood pressure, then shot a rapid-fire array of questions, which Josh did his best to answer.
‘Are you dizzy or light-headed?’
‘A bit dizzy.’
‘Have you vomited?’
‘No.
‘An
y feelings of nausea?’
‘No. I don’t think so.’
‘Abdominal pain?’
‘No.’
‘Headache?’
‘Yes.’
‘Is it bad?’
‘Not really. Kind of a mild throbbing.’
‘And how is the bite area feeling?’
‘It’s hurting. But it’s still not too painful. Sort of like someone’s hit me. But it is getting worse.’
Then Matt was back with bandages and a splint. They put a gauze pad over the bite, which was still bleeding, and then wrapped it up tightly. They put Josh’s whole leg into a splint – two metal poles either side, with straps that immobilised the leg. Then they got the stretcher from the ambulance. It was a complicated-looking thing with wheels and bits that extended, allowing it to go up and down.
‘Can we come with him?’ asked Sally, voice unsteady, indicating her and Pete.
‘That’s not really possible,’ said the first paramedic.
‘I am sorry,’ added Matt.
‘Don’t youse worry,’ said Ratchet, stepping forward. ‘I’ll drive ya to the hospital.’
‘Thanks.’ Sally smiled at Ratchet, then looked to Josh. ‘It’ll be okay.’
‘Hang in there,’ said Pete, awkwardly.
‘Dad,’ Josh suddenly remembered. ‘Pete, could you call him and let him know what’s happened?’
‘You can use my mobile,’ Ratchet said to Pete.
The paramedics carefully lifted Josh onto the stretcher they had placed flat on the ground beside him. Then they carried it over to the ambulance and slotted it into place. The paramedic who had examined him got into the driver’s seat, while Matt climbed into the back with Josh, closing the doors.
As the engine revved and the ambulance started to move, Josh could see Sally, Pete and Ratchet staring at him through the back window. Marceline was behind them, ordering the other kids around and getting them to continue with the clean-up.
‘Don’t worry about Jeff,’ said Matt. ‘His bedside manner’s not great, but he’s good at his job.’
‘Jeff?’ Josh looked at Matt.
‘The other paramedic,’ explained Matt. ‘He never introduces himself. He just gets straight down to business, uses a lot of technical terms, never explains anything … and always does the driving. He likes to drive.’
‘Am I going to be okay?’ asked Josh. He was feeling rather overwhelmed by everything. It had all happened so quick. The pain was getting worse. And now, here he was, in an ambulance being carted off to hospital.
‘Sure you will,’ said Matt reassuringly. ‘Lots of people get bitten by snakes. You just need some antivenom.’
‘Then why do you need the RFDS standing by?’ he asked.
‘It’s a matter of what sort of snake bit you,’ explained Matt. ‘If it’s an ordinary brown snake, then we have the antivenom on hand at the hospital. These snakes are fairly common around here and their venom is pretty fast-acting, so we always have it available. But if you were bitten by a King Brown snake, then you have to go to Adelaide. King Brown bites are a lot more rare and we don’t keep any antivenom for those. But don’t worry, the King Brown venom is slower and we have plenty of time to get you to Adelaide.’
A wave of nausea washed over Josh and his head spun.
‘I’m not feeling so good.’
Josh was wheeled into an emergency room, where beds and stretchers with patients were separated by plastic curtains. It made him think of a giant bathroom because his grandmother had white shower curtains that looked a lot like these.
Josh expected the hospital to be really quiet. Sick people need silence, don’t they? he thought.
But this area was full of sounds. Lots of doctors and nurses and orderlies were bustling about talking to the patients and to each other, people on wheeled stretchers were being moved about, curtains were being drawn back and forth with a swoosh, and medical machines and monitors were making pinging noises.
He wondered if it was like this for Mum and Nate. Are there noises and movements all around them? Are they confused? An image of Mum, lying in a hospital bed surrounded by a flurry of activity, flashed into his mind. She looked scared.
Josh’s heart pounded. His breathing quickened.
He was relieved when Matt drew the curtains. He took a deep breath and tried to banish the images and calm himself down. A doctor promptly arrived and the paramedic filled her in on what had happened, before heading off with a wave and a ‘See you round, kid.’
Introducing herself as Pam, the doctor asked Josh all the same questions the first paramedic had. He let her know that his headache was now worse, he was feeling quite dizzy and his leg was throbbing with pain.
Putting on a pair of latex gloves, Pam removed the splint, bandage and dressing to examine the wound. It had swollen up and was looking bruised. Blood oozed from the two punctures. Josh winced when she touched the area.
‘It’s still bleeding because the snake venom has an anti-coagulant in it,’ she explained. ‘That, combined with your symptoms, means that envenoming has occurred.’ When Josh looked at her with a quizzical expression she elaborated. ‘Envenoming simply means that the venom has actually gotten into your system, so we need to make sure to get some antivenom into you. Now, I’m told it’s reasonably sure that you were bitten by a King Brown, but we need to be absolutely certain. We don’t want to give you the wrong treatment. So I’m just going to get a Venom Detection Kit and conduct a little test. Okay?’
Josh nodded. A wave of nausea and dizziness overcame him and he closed his eyes for a moment. Next thing he knew, Doctor Pam was back.
‘This is going to sting a bit,’ she warned. ‘Sorry.’
Using a long cotton bud, she poked at one of the punctures. Josh gasped and gritted his teeth. The doctor then put the swab into a little bottle.
‘This will take about ten minutes,’ she said and disappeared again.
Josh’s heart pounded as he waited, his mind going through worst-case scenarios. What if they couldn’t identify the snake venom? Then what? Did they just keep pumping him full of different antivenoms, until one worked? Or would he die? A horrible, slow, painful death?
And then he realised that he was alone. What happened to his friends? Didn’t Ratchet say she would bring them? Why weren’t they here? His heartbeat quickened.
How long has it been? he wondered Shouldn’t the test he finished by now?
Doctor Pam came back in. ‘Okay,’ she said. ‘It’s definitely Mulga venom, so we’re going to have to get you to Adelaide for the black snake antivenom.’
‘Hang on,’ said Josh, voice shaky. ‘So it wasn’t a King Brown?’
‘Sorry,’ said the Doctor. ‘Mulga is another name for a King Brown. It’s also sometimes called a Pilbara Cobra.’
‘So then it needs brown snake antivenom,’ insisted Josh, his voice still strained.
‘No,’ explained Doctor Pam, patiently. ‘The King Brown is not actually from the brown snake family. King Brown is probably a silly name for it. It definitely needs the black snake antivenom.’
‘And where are my friends?’ Josh was working himself up into a panic. ‘Why aren’t they here? What’s happened to them? They said they were coming.’
‘It’s okay. Relax,’ said Doctor Pam, placing a reassuring hand on his shoulder. ‘They’re in the waiting room. I’ll get you moved out of emergency, then they can come and visit you. But first I’m going to put some numbing gel onto your hand. We’re going to have to attach an IV drip, so this will make sure the needle doesn’t hurt. And then I’m going to put a compression bandage on your leg. That will slow the movement of the venom through your system.’
Josh took a deep breath, trying to calm himself down. ‘Okay.’
An orderly wheeled Josh into a waiting area, which was little more than an alcove with a couple of chairs. The pain was making it hard for him to think straight and nausea was starting to build up.
‘I think I’m going
to be sick,’ said Josh.
The orderly calmly reached under the stretcher and pulled out a sick bag, holding it in place just in time. Josh vomited, his breakfast splashing into the plastic bag, with a few stray splatters hitting the floor.
When he finished, the orderly quietly cleaned it up and passed Josh a clean bag. Josh clung onto it, the sour taste of orange juice and milk mixed with stomach acid still in his mouth.
As the orderly left, Sally and Ratchet came in. His first thought was, Where is Pete? Why isn’t he with them?
‘The doctor told us the RFDS are going to take you to Adelaide,’ said Sally.
Josh was about to ask for Pete when a nurse came in. She checked his blood pressure and heart rate, then attached an IV drip, inserting a needle into the vein on the back of his left hand and taping it down. She connected a plastic bag full of liquid to the drip and hung it from the metal rod attached to the top corner of the stretcher.
‘I’m giving you some painkillers and anti-nausea medication,’ said the nurse. ‘It should make you feel a little better.’
Pete came running in clutching a mobile phone. The nurse glared at him and he slowed down, handing the phone to Ratchet, who was standing uncomfortably in one corner. Her bulk made her look and feel quite awkward in the small space.
‘I’ve been talking to your dad,’ said Pete. ‘There’s no way he’s going to be able to make it here before you’re flown off. He said he’d ring your mum in Adelaide and that she’d be at the hospital waiting for you.’
‘Did he say anything else?’ asked Josh.
‘Something about your aunt not being there anymore,’ said Pete. ‘She’s gone home, he thinks.’
‘Anything else?’ Josh’s voice rose.
‘No,’ said Pete. ‘Sorry.’
Josh felt disappointed. Empty. He was hoping that his dad might have said more. That he loved him? Just something. Or that he would at least try to get here before the RFDS took him away.
The orderly came back. ‘Okay, time to go,’ he announced, taking hold of the stretcher.
Medical Mission Page 5