The Hollow Men: A Novel

by Rob McCarthy

  ‘And my first responsibility is getting all five hostages out of there alive, so I’m afraid your patient’s health is not high on my list!’

  Harry said nothing. One of the paramedics passed him an oxygen cylinder and he took it by the handle.

  ‘How serious is it?’ Quinn asked.

  ‘Without proper medical attention, he might not last more than a few hours. Maybe not even that. He’s heading into respiratory failure.’

  ‘Just hypothetically,’ Quinn said, ‘if we went in there, is he still capable of pulling the trigger?’

  ‘I can’t answer that; I don’t know. He’s incredibly weak. I doubt he’s capable of running more than a few metres before collapsing. In this state, he isn’t much of a threat.’

  As he said the words, Harry realised they were false. It didn’t require much strength to lift a gun and pull a trigger: that’s why people used them. Firearms were great equalisers.

  Noble shot Quinn a crystalline look. ‘That’s staying hypothetical, Inspector,’ she said. ‘We’re not going in unless he makes a move. I am not going to let the Met shoot dead a young kid on my watch. This is my fucking patch, and I do not want it turning into Tottenham in summertime, understood?’

  ‘Absolutely.’

  ‘Good. You ready, Dr Kent?’

  Harry nodded. As I’ll ever be, he thought. Ready to walk back into a place armed police had been forbidden to go, with his only protection lying on the tiled floor. He heard the sound of the helicopter overhead and for a second was back in the mountains. He felt the same fear, the same taste of adrenaline, as he had in the field. Discounted it, put it down to the amphetamine he’d taken.

  Noble’s voice destroyed the memory.

  ‘Inspector Quinn, have your men walk Dr Kent back in.’

  Harry went back into the restaurant and the bell rang again. Both of the takeaway employees looked up towards the door, creatures of habit.

  Idris was clutching the clinical waste bag and looked even worse. Those lungs had to be seriously diseased, he thought, for him to have deteriorated in the short time Harry’d been outside. Seventeen was too young for cancer, even though Idris had said he’d lost weight. If it was indeed pneumonia, then it had already progressed to the stage where his lung function was significantly impaired if he was running sats of eighty-seven. A lung abscess was possible, as was TB, even though Idris had denied going anywhere exotic. But these days, London was exotic enough.

  ‘When’s the lawyer coming?’ Idris demanded.

  Harry got out a non-rebreather mask from the oxygen cylinder’s bag and connected it to the valve, turning the gas supply on.

  ‘I don’t know,’ he said, passing it to the teenager. Idris tossed it back to him.

  ‘You first, bitch.’

  Harry laughed. Of course kids of Idris’s age distrusted the police, but that level of paranoia was something new. He wondered if the fear in Idris’s eyes was something else, whether he was psychotic. As a young black man, he ticked most of the risk factors for schizophrenia. But those diagnoses could wait until they had him physically stable. Harry put the mask to his face and took a few deep breaths of the oxygen, then connected a sterile one to the cylinder and passed it over to Idris, who sealed it over his face and took long, laboured breaths. Each time he looked scared it would be his last.

  ‘If you need to cough again, take the mask off and cough into the bag.’

  Idris nodded placidly. They sat in silence again while Harry checked the reading on the pulse oximeter. Eighty-nine, little change. His pulse was elevated too, a hundred and eighteen. He turned up the oxygen to four litres.

  ‘Fuck’s sake!’

  The voice was from one of the five hostages, the fat, greasy man with the smiling cockerel on his polo shirt. Harry closed his eyes and felt his heart thump in his chest. One thing he’d learnt growing up in Lewisham, which had been reinforced by the military: keep your fucking head down.

  Idris looked round slowly, like it was taking all of his physical effort.

  ‘Yeah?’

  ‘You gonna let me turn the heating back on? Or you gonna freeze us all to death?’

  Harry had noticed the cold when he’d first entered the room, but then he’d forgotten it. Maybe it was the stress, the adrenaline warming his core. But he felt it now, biting at his skin, easily as icy as it was outside.

  ‘Too hot,’ was all Idris said.

  Harry took Idris’s wrist, the one not resting on the gun, and felt his brow with his other hand. He was sweating profusely, the skin warm to the touch. Systemic fever. The infection in his chest was spreading. He could have septicaemia already.

  ‘Solomon,’ he said. ‘Listen to me.’

  Idris coughed and looked up. His words were muffled by the mask, but Harry had heard the question so many times he could lip-read them without effort.

  ‘Allow it, mate. Am I gonna die?’

  He said it with the nonchalance you might expect from someone on the street asking if it was going to rain later. Harry gave his stock reply. ‘Not if I can help it.’

  Idris pulled off the mask and coughed violently into the bag, the plastic shaking as each expulsion of bloody mist hit it.

  ‘Solomon, we can help you, OK? But you have to let these people go.’

  Harry winced inwardly, as if Idris was about to raise the gun and shoot him for sounding patronising.

  ‘I think you’ve got a serious lung infection. I can give you some fluids and drugs to bring the fever down, and the oxygen will help you breathe better. But only for a while. It might buy you an hour or two. You need to get to a hospital now, or you’ll be in big trouble. So let these people go, get in an ambulance with me, and don’t give them the satisfaction.’

  Idris looked up at him. Harry watched him actually considering what he’d said, seeming to weigh everything up. Was that what this was, suicide-by-cop? If that was the plan, maybe Idris was working out if he didn’t need to provoke them into shooting him. It might be easier to simply fade away, let the disease take him.

  ‘I want the drip,’ said Idris. ‘But no hospitals.’

  ‘OK. Are you allergic to anything?’

  ‘Penicillin.’

  Brilliant, Harry thought. That ruled out most of the drugs he’d want to start with, and all but one of the antibiotics he carried with him. He reached into his bag and pulled out a cannula, a tourniquet, a sharps bin and a packet of saline. Tied the tourniquet around Idris’s arm, started searching for a vein in his elbow. The sweat on his skin, and the shock from the infection, made them hide, so Harry went down to the wrist and found a bulging one on the dorsal surface of his hand. He rested the drip on top of his bag, twisting the valve and letting the fluid start running into Idris’s system. He watched the teenager wince as he taped the cannula to his arm.

  No hospitals. There was only a limit to what he could do here. Examine him, provide initial care. He didn’t carry any antibiotics powerful enough to treat the infection which Idris could safely receive, just oxygen and fluids. And he really needed to get an X-ray. Maybe if he could get Idris talking, get him to trust him, then he would agree to come with him. He tried to pick his words, to sound friendly, approachable.

  ‘What’s this about, Solomon?’

  The words were out of his mouth before he had time to regret it. It wasn’t his job to get this kid out of here, it was DI Noble’s – wherever she was, and whatever she was doing. Which at the moment looked like nothing.

  The reply came through another bout of coughing.

  ‘Keisha.’

  ‘Who’s Keisha?’

  Idris erupted into coughing, his head jerking as if he was headbutting the orange bag. When he was finished he wiped his eyes and looked up at Harry. That look was there again. The one that said the teenager had seen things he shouldn’t have. How many seventeen-year-old boys can look people in the eye and say they’ve come close to dying?

  ‘You don’t give a shit, bruv.’

  ‘You g
ive a shit, don’t you?’ said Harry. ‘You wouldn’t be doing this otherwise.’

  ‘Fuck you.’

  Were those tears in his eyes? Tears from the fever, the shortness of breath, or at his situation? He might have a gun, not to mention a criminal history most adults would shirk at, but here he looked vulnerable.

  ‘What happened to Keisha?’

  ‘She died. They fucking killed her. Killed her and you feds didn’t give a shit.’

  The crap in Idris’s throat punctuated his speech, each word like a silenced gunshot. The words ran through Harry’s mind like the raindrops down the shop window, some meeting up and merging along the way.

  ‘Who killed her, Solomon?’

  ‘Not talking to you. These ends, you don’t talk to the feds. You talk to the feds and mandem get you.’

  ‘I’m not with the police, Solomon,’ said Harry, aware that he sounded as desperate as he was. ‘I’m a doctor. I don’t work for them. I don’t do what they say. Let me get you to the hospital, and we can talk about Keisha while we’re getting you better.’

  ‘Gonna talk about Keisha when the lawyer comes. Gonna tell him and the BBC.’

  Idris descended into coughing, the longest and most violent episode yet, now so short of breath he could barely form sentences. His head came slowly back up from the bag, and he replaced the mask. He raised a hand, palm open, and even that movement looked like it took most of his effort.

  ‘Unless you let us treat you, you might not make it that long,’ Harry said. It was on the dramatic side, but he wasn’t sure if Noble and the other police officers had any intention of granting the requests. He went through various scenarios in his head: he could take blood and have the police courier it to the hospital for tests. The messenger could return with broad-spectrum antibiotics usable with a penicillin allergy. He could start intravenous paracetamol to bring down the fever. But even that might not buy Idris more than a few hours.

  Not good enough. Pulse elevated, pyrexic, respiratory rate up, blood pressure holding for now, but Harry had that hunch, that gut feeling, that told him it would crash at any minute. Patients like this were the ones he got called to on the wards because the nurses and the junior doctors were worried about them.

  ‘When we get to hospital, we might have to sedate you so we can take control of your breathing and give you more oxygen,’ Harry continued. ‘We really don’t have a lot of time here.’

  He thought about it. He had sedative drugs in his bag. Midazolam, ketamine, morphine. Would Idris buy it if he said it was an antibiotic for the infection, but gave him a bit of midazolam, enough to knock him out and let the police come in safely? Maybe not when he’d first come in, Harry thought, but now the teenager trusted him, it was possible.

  Possible, but morally abhorrent. He’s your patient, and you do what’s best for him. That’s the first commandment, the unbreakable law. Noble’s looking out for the hostages, the ‘other people’. Nobody else is looking out for the kid with the gun and the haunted eyes.

  ‘Talk to me about Keisha. I’ll tell your lawyer, I’ll tell whoever you want.’

  ‘Feds didn’t give a shit then. They won’t now.’

  Harry leant forward.

  ‘I don’t think—’

  The gunshot was loud, cutting through the cold air, somewhere to Harry’s left. His earpiece exploded into life.

  ‘Shots fired!’

  Harry’s eyes flashed down to the gun on the table, to Idris’s hand, which reached towards it, the clinical waste bag dropping into his lap.

  ‘GO! GO! GO!’

  Feet crashing onto concrete, Harry diving for Idris, screams from the hostages, the bell of the opening takeaway door. Idris ducking sideways, hand sluggish, finger groping for the trigger, Harry rolling onto his back, men in black in the doorway.

  ‘DON’T SHOO—’

  Crack. Splitting windows and rolling off the walls.

  ‘—T HIM!’

  Nothing but ringing in Harry’s ears.

  ‘He’s down!’

  Police flooded into the restaurant, some with guns raised, others grabbing the hostages and dragging them out into the night. Idris was on the floor, awkwardly propped between the counter and the table, blocked from Harry’s view by his medical bag. He felt hands on his shoulders, pulling him up.

  ‘Doc, you hit? Are you OK?’

  He patted himself down, waiting for the adrenaline to subside, for the pain of the wound to strike, but nothing came. A tight agony spread from his chest to his right flank, and he felt alive, his vision heightened, his ears ringing. This was a feeling he knew. This was the fear and rage of war, in a chicken shop on the Camberwell Road.

  Harry pulled himself to his feet.

  ‘I’m fine. Get the medics in here, now!’ he said.

  A low moan from behind the table. A pair of Trojan officers who’d come in the back were patting Idris down, checking him for weapons. Harry grabbed the table between him and the teenager and threw it to one side, a leg snapping off as it hit the wall. He tapped the officer closest to him on the shoulder.

  ‘Let me through.’

  Quinn was there now, his voice calm, the eye of the storm.

  ‘Dr Kent, we need to get you out of here.’

  Harry ignored him and knelt down. Idris was still conscious and moaning loudly, his eyes flickering between the various people crowded over his body. Harry cut off the hoodie with shears from his medical kit. He could see the entry wound, over to the left of Solomon Idris’s torso, underneath the curve of the ribcage. Probably too low to have hit the heart. Hopefully. But there was something hit, it was leaking blood, crimson against the white floor tiles.

  ‘Clothes off!’ Harry shouted. ‘Cut his clothes off!’ He patted Idris down, checking for other wounds. Found blood on the left wrist but it was just where the cannula had been pulled out as he fell. He reached underneath and felt for an exit wound, but there wasn’t one.

  ‘Stay still! Stay fucking still!’

  The shouting was one of the Trojan officers, weapon still trained on Idris’s chest.

  ‘Gun’s clear!’ said Quinn.

  Idris was thrashing on the floor, a combination of shock and fear. Like this, Harry could do nothing – couldn’t place another IV line, couldn’t keep him on oxygen, couldn’t dress his wounds.

  ‘Get pressure on that wound and hold him down!’ he barked.

  He reached over into his medical pack, putting the anaesthetic kit on the table in front of him and biting open the packaging of an intramuscular needle. He kept preloaded syringes with standard doses of anaesthetics ready to save time.

  ‘Scene is secure, get the medics in here!’ Quinn said into his collar mike. He was holding a clear plastic bag with the gun inside. Four Trojan officers were holding Idris to the ground as he struggled and thrashed, their weapons slung over their backs. One, wearing only a sidearm and with a green cross on his helmet, had managed to get gloved hands and a white dressing over the teenager’s shoulder.

  ‘Trigger-happy pricks,’ Harry muttered, attaching the needle to a preloaded syringe. Working out the dosage in his head. Sixty-kilogram teenager, ketamine in the muscle, call it seven hundred to be on the safe side.

  ‘He fired first,’ Quinn said.

  ‘Save it for the inquest,’ Harry said.

  He knelt down by Idris’s thrashing body and aimed the needle at the large deltoid muscle over the teenager’s good arm. Went in and was met by a pained moan, before the thrashing slowly subsided. Noise drifted in from outside as the ambulance pulled up, and the Trojan officers began to retreat, letting the paramedics through.

  ‘Jesus Christ, is he dead?’

  The officer who’d fired the shot was young, maybe just twenty. The way he was shaking told Harry everything he needed to know about how he was handling the situation. Quinn grabbed him by the arm and led him towards the back exit, away from the massing crowd.

  ‘The doctor’s sedated him, Greg. Let’s go.’


  Harry lifted the dressing off the wound to inspect it further – it was still bleeding, but not catastrophically. Looked venous, not arterial. There was always the risk of a major structure being damaged internally, but nothing he could do about that now. The area where Idris had been hit was rich with large blood vessels and vital organs: spleen; kidney; gut. All of them could exsanguinate if they were hit. If they managed to save the kid’s life, it would be on the operating table.

  Harry considered working on him there, securing another line, intubating him on the floor of the Chicken Hut, transferring him to the hospital once he was stable, but with the Ruskin no more than five minutes away on blue lights it wasn’t worth the delay – every second he spent at the scene was another one Idris was losing blood without replacement. Just like Helmand, he thought. Get the casualty out of the hot zone and run for their life.

  ‘You’re the police doctor?’ one paramedic said.

  ‘I’m an ICU registrar, too,’ Harry said. ‘Can we scoop him onto the trolley?’

  He was waiting for the paramedic to take over, but she simply nodded and ran back towards the ambulance, leaving her partner waiting there. Harry stepped into the void.

  ‘Get a line in, as quick as you can.’

  The paramedic knelt by Idris’s exposed arm and started searching for veins, and Harry replaced the pulse oximeter on the teenager’s finger. Got his stethoscope to examine the chest, and was relieved to still hear breath sounds, albeit dull, on the left side, even lower down, right near the wound. There was no way to tell if the dullness was due to infection or an internal bleed.

  ‘Sats are eighty-one.’

  Still heading down. Harry reached over to the oxygen cylinder and picked it up, switching it to maximum flow, fifteen litres a minute, as the female paramedic returned with an orthopaedic scoop stretcher, which she broke in half. Harry placed it at one side of their patient, the paramedic mirroring him, and they joined the halves at the head and feet and arranged themselves either side of the scoop.