Perfect Skin

by Nick Earls

  We’ll get her, he says. If she’s in there we’ll get her.

  The axe splits the door with one blow, and they heave it open. Hot smoke billows out onto all of us. I break free again and I push inside. I drop to the carpet and I crawl along the corridor. I have no idea where anything is. There’s no air, no air here. I’m as low as I can be, but I’m not below the smoke.

  They grab me by the legs, and pull me out. I can’t fight them this time. I cough till I throw up in the garden. I’m dizzy and on my knees. My back’s hot from the fire in the kitchen above, scorching me through my T-shirt.

  We’ve got her, the guy I’ve been battling says. Mate, we’ve got her. She was round the back.

  Oh, thank god. So she was out?

  No. Nearly out. She was on the floor near the back door. But she’s out now. And we’re giving her oxygen and the ambulance’ll be here any second.

  I’m a doctor. Maybe I can help.

  You’re a doctor?

  Yeah. Yes. I’m a fucking doctor. This woman means a lot to me and I’m a doctor, so let me help. Please.

  I stand up and the coughing starts again. In the black of the trees, I see sparkles and my knees start to bend.

  I’m on the ground again. My hands are on Ash’s path, opened wide and holding me up, lit orange from behind by the flames. Oxygen is fitted to my mouth and there’s an arm around my shoulders. An ambulance trolley pushes past through the long grass and up the side of the house. I pull the mask off and start hitting the arm that’s holding me.

  It’s okay. I’m okay. I’ve got to help.

  When we get round there, they’re checking pupils. I can see Ash, crumpled on the ground, not conscious and, in the smoky haze, the small, white cone of light dropping down onto her eyes, checking each of them.

  I can hear a voice say, We’ve got a doctor here, as I move past, towards her, and one of the ambulance crew turns to me and says, Smoke inhalation. No apparent burns. She’s not conscious. We’ve got her on oxygen now. Her heart rate’s one-fifty, we’re just checking her BP.

  And the pupils?

  Normal. We’re about to get her off to the Royal quick smart.

  They lift her onto the trolley and fold one flopped arm back out of the way, leaving her half-open hand next to her face, just the way it was last night. I take it to hold it, but it’s limp.

  Why not the Wesley? It’s closer. I’ll sign for it, for the cost.

  They’re on ICU bypass. Full tonight. Big prang on Milton Road. But don’t worry, doc, you haven’t seen how we get to the Royal.

  In the light at the back of the ambulance Ash looks grey, streaked with grime on her forehead where she pressed her hands to hold the smoke back.

  I start coughing again, and spit some very bad-coloured mucus into the gutter.

  And one for you, the ambulance guy says, and fits an oxygen mask around my head.

  I take the stethoscope and I check Ash’s chest. There’s air everywhere that there should be, as far as I can tell. But the ambulance is moving now, we’re on our way, so it’s hard to hear. Then the sirens cut in.

  I’m Dane, he shouts over his shoulder as he’s sticking on ECG electrodes. And Julie’s the driver.

  I’m Jon. I’m actually a friend of hers. And a doctor. A laser surgeon.

  Still, it’d be like riding a bike, this stuff, hey? Hopefully? Shall I get a bag of fluid ready? Are you going to get a line in?

  Yeah.

  I take a tourniquet and find a vein on Ash’s forearm. I rub away at the skin with a swab, cleaning as much of the smudged smoke off as I can, and the vein feels full and plump under my fingers. Almost too good. I’ve blown veins like this before. But that was years ago, and it was confidence that blew them, inadequate attention to detail.

  Streetlights flash by, a car buzzes past going the other way.

  I pick the cannula and slip it from its sheath. I palpate the vein again.

  We take a corner fast and it throws me down onto one knee. I look out the window. The road will be straight for about ten seconds.

  Keep it still, I tell myself. Don’t go deep. Nice and steady.

  I push the tip forward and the skin dimples, gives. There’s a flashback of blood in the cannula. I ease it further in to make certain, unclip the tourniquet.

  Here’s the line, Dane says, and hands it to me. And the next corner.

  I brace myself for the turn and, when we’re through it, I connect the drip up. It runs. I loop the line down to her wrist and back, and tape it securely.

  She’s got quite a tachycardia going, he says, and points to the ECG. Or is that just a problem with the trace?

  No. Fuck. They’re ectopics. They look like ectopics, on top of the tachycardia. The wandering baseline just makes it hard to read.

  Problem?

  Yeah. Could be.

  Then there are more.

  Jesus, Ash. Don’t do this.

  More. A couplet. Another couplet.

  Have you got all the gear for cardiac things?

  Yeah. But you’ll be the one using it. I’m not a paramedic. We’re just a regular ambulance, not the cardiac one. We’ve got gear though. Just tell me what you need.

  Okay.

  And her BP’s down to eighty systolic. Maybe seventy. What’s normal for her?

  She’s having couplets now, I tell him. You see those ectopics there? Two in a row. Then another two in a row. That’s what it looks like. If this gets more unstable we could be in trouble. Have you got any lignocaine, or bretylium?

  Yeah, I’m sure we do. Let me get them.

  Thanks.

  Another couplet. A run of three in a row. Sailing silent and misshapen from right to left across the monitor, as the siren doubles its frequency and we glide through a red light.

  Have you got a defibrillator?

  The words even sound as though they’re being said by someone in another life, or on TV. I’m out of my depth here. These drug names are just memories for me, and I’m about to go guessing with them. If lignocaine comes in 100 mg ampoules, that’ll be my guess. That’ll be what she gets. I’m holding her hand as he fetches the drugs. I’m watching the ECG. Watching it tell me heart rates that are swinging round all over the place, all of them too high. We lurch round another corner. I slip, I hit my head, my oxygen mask falls off. We’re going through the city now. I can see the lights out the window. One of the defib paddles goes near the sternum. The other I’m not sure. Hopefully it’ll say on there. It’s been too many years.

  And that’s when it really hits me. Ash might be going to die. I’ve seen this before, held the limp hand, watched the monitor go all wrong.

  Don’t do this, I tell her. Please don’t do this.

  And I’ve left Lily in the car.

  Lignocaine? It was lignocaine you wanted first?

  Whichever.

  I’ve left Lily in the car.

  I only need one of them, I tell him.

  He hands me something, takes another BP.

  Still eightyish.

  Good.

  I’ve left Lily in the car, and there’s nothing I can do. Nothing I can think of. I watch the monitor. I get ready for it all to get worse, and to demand that I try something. I imagine defibrillating. I imagine it failing, Ash jolting and dying there. And I push that out of my head. I imagine it working, and I imagine the routine, where the paddles go, setting it to three hundred joules and hitting the red button. Sometimes it works, that’s what I tell myself.

  I let go of Ash’s hand. I tear the top from the lignocaine box. I tip the parts out. I remember it from uni. It’s a single-dose set. I screw the vial down into the syringe. We’re in the Valley now, almost there.

  And the couplets settle down. Peter out, like a storm passing.

  Single ectopics slide across the screen, then they’re gone too. There’s a tightness around the fingers of my right hand, Ash squeezing. I’m holding her hand again. She murmurs something inside her mask. She’s looking at me.

&n
bsp; There’s been a fire, I tell her. But it’s all going to be okay.

  She nods. I keep watching the screen, trusting nothing. I keep the lignocaine in my other hand, just in case.

  Dane . . .

  It’s looking better, isn’t it? The ECG?

  Yeah, much. I’ve left my baby in the car.

  Shit. Um . . . We’ve got a phone. Is there anyone you can call?

  Yeah. Thanks. What’s the time?

  Three-ten.

  Right. So, well after everybody’s bedtime then. Don’t know why I asked really.

  I swap him the lignocaine for the phone, and I call George and Oscar’s number. It rings four times and the answering machine cuts in, George and Oscar sharing the outgoing message, with some lounge music in the background. It beeps and I tell them, Pick up, pick up. Please pick up. It’s Jon. I really need you to pick up.

  Then George’s voice is there, a bleary Hello.

  George, it’s Jon. I need you to do something for me.

  Hmmm.

  Are you awake?

  Yes.

  There’s been a fire at Ash’s place. We’re on the way to the Royal. Everything should be all right, except I left Lily in the car.

  What?

  I need you to go and get Lily out of my car.

  But I don’t have a key.

  Break a window. Now, I’ll give you the address.

  He takes it down, reads it back to me and sounds more awake now.

  I’m on my way.

  Thanks.

  I’m feeling sick again. I put the mask back on.

  We make a left turn, and then sweep into Royal Brisbane Hospital. The doors of the ambulance open, and the back fills with fluoro light.

  Let me sit, Ash says, and we click her up into a half-sitting position.

  Before they pull her out, she reaches out to me, puts her arms around me and draws me in to her, our oxygen masks nudging each other in a soft plastic clunk, like a collision of two Star Wars characters.

  Even with the mask on, I can smell the smoke in her shirt, my T-shirt.

  Let’s get you out of there, someone says.

  22

  You’re wearing a doctor thing, Ash says, when she turns to look at me. She blinks at the bright sky behind me and looks back at the ceiling.

  That’s because I stink. No, it’s routine. Everyone in here wears one of these over the top of their regular gear. It’s to do with infection control. Of course, every bug on my skin got smoked out about four or five hours ago.

  What happened?

  It was probably your wiring, but they’ll work it out.

  Weren’t you at home? How did they know to call you?

  They didn’t. Lily’s teething. We were out driving. I was probably focused on the anti-wailing measures, so I must have automatically found my way onto our running circuit and followed it. The fire-engines were getting there when we did. The crew had to keep tackling me to stop me helping. Poor bastards, I’m sure they know what they’re doing. And then I left Lily in the car.

  She’s all right?

  Yeah. George got her. Smashed a window. Took her and my phone and my wallet and drove off with the alarm going. I hope those things stop after a while. She’s with my parents. He was here not long ago, before work, to see how things were going. So he brought the phone and the wallet. And some grapes for you.

  She half-smiles, and looks as though the effort tires her. You guys and your grapes.

  Do you want to get some sleep? Do you want me to go?

  No. Oh, have you got to go to work?

  No. It’s Monday, so I’m off this morning.

  I want to sit up. Can you help me sit up?

  Sure.

  I help her lean forward, I reshape the pillows and I slide her back against them. She sits with her crepe-bandaged drip arm on top of the covers, and she squints out the window.

  Where are we?

  Royal Brisbane.

  Hmmm.

  Do you know where that is?

  No. Is it a long way from home?

  From St Lucia? Not too far.

  She nods, looks around the room. There are three other beds, two of them with people in, both ventilated.

  Oh, what am I going to do?

  First, you’re going to get well. You were lucky to get out really. And there were a few scary moments in the ambulance. I was pretty worried actually. Your heart was doing some things it shouldn’t. Which is why you’re in here on a monitor, but it’s been normal all night.

  What was happening?

  Rhythm problems. That’s how it looked anyway. It wasn’t easy to read. But they sorted themselves out. There was a minute or two when I was really, really worried that they weren’t going to. Shit, even seeing you in a hospital bed scares me. I hate this stuff, you know?

  Yeah. She starts to cry. I pass her the tissue box, put my arm around her. She puts her head against my shoulder and says, You stink. You stink like my mouth tastes.

  Just cause I wasn’t sick enough to get bathed.

  Oh . . . she groans. What am I doing? What am I doing here?

  It’ll be okay.

  Oh, Jon. What’s going on? My life is fucked.

  It’ll be okay.

  She lifts her head, looks me in the eye.

  You’re okay.

  Thanks. She puts her head back on my shoulder.

  And I want to do whatever I can. I want it to work out for you here.

  She pulls tissues out of the box and wipes her face.

  Um . . . I don’t know what’s happening. I mean, I’m here for this year, but I don’t know. Maybe for longer. I’m not in love with you. You know that, don’t you? I don’t know what it is that’s going on, but I don’t think I’m in love with you.

  That’s all right.

  Is it?

  Yeah. I don’t think that’s what either of us was looking for. So it’s fine.

  She puts her arms all the way around me, and her IV line hooks itself onto my ear. She smiles, and carefully lifts it free. It’s as if the dangers of last night give us a more immediate need for clarity today. I think we both sense it. That we have to pause, if only momentarily, and actually define things before we move on.

  And of course she doesn’t love me. We’ve only known each other a few weeks. And she might think we’re like each other – we both might think that – but we can’t ignore the differences either. It’s good that she’s talked about it. Probably good, too, that she doesn’t love me. Who knows where that could have led?

  So what are you looking for? she asks me.

  What do you mean? I don’t think I’m doing much looking. I’m looking to get through each day, I guess.

  But you’re already good at that.

  What do you mean?

  What I said. You’re already good at getting through each day. What’s the next phase?

  I guess I’ve been leaving that to work out later.

  Yeah. This time I’m not going to say one of those things like, ‘Sometimes you seem to be leaving a lot till later’.

  I can hear the sigh I let out, but not even I’m sure if it’s exasperation, or resignation, or just plain tiredness.

  Sorry.

  Don’t be sorry. Let’s not go back to sorry. It seemed to lead to such a crappy night.

  She laughs.

  You know, no-one’s put it to me that way before. They haven’t – and this is what you’ve been saying – they haven’t dared. They’re behaving like people who have come home after they were supposed to, and they’re taking their shoes off so that the bad guy in the house doesn’t wake. But that’s okay, too. They’re there for me. I know that. And I wouldn’t want them any other way. And, yes, maybe I do leave things. Maybe I can get away without crying my eyes out over this, so why shouldn’t I try? And maybe I do keep things in, but what do you want me to do? I’m grinding my way through this, and that’s a day-to-day thing, but I am getting through. And you’re now a part of that.

  Good.


  But it’s not so much what’s happened that I have to deal with. It’s what will happen. People think it’s the past that I’ve got to deal with, and I do, but it’s only part of it. And it’s a part I can’t change. It’s the future that I’ve got to think about more. And the past that I have to accept. Find a place for. Take apart piece by piece and put away somewhere. And that hasn’t been easy, and it’s not going to be easy, and you and everyone else can’t tell me it’ll be otherwise.

  She looks up at me, but she doesn’t say anything.

  Sorry. You’re not trying to tell me that . . . Okay, I’ll be honest with you. Totally. This is all knotted up. Fairly knotted up. All the way in. And there are things I haven’t told people specifically because they were Mel’s friends too. So maybe I can tell you some time.

  Go on.

  What?

  Tell me.

  Now?

  I get bored in hospitals.

  So I tell her about Lily’s conception, Mel’s absence and her return. The drinking that night. The desperate hope with which I invested that last chance. How we ran to the taxi rank as rain started to fall, storm rain that drummed on the roof as we drove home, that soaked us when the keys slipped from my hand at the front door.

  You idiot, Mel said as they fell between the steps. You idiot. But she was laughing.

  How it was my idea not to use contraception, even when Mel was clear about the timing. Particularly when Mel was clear about the timing. My excitement when the pregnancy test was positive a couple of weeks later. My hope – having fallen for the hope she’d once had about what a family would do – that this would make everything good. And we argued another nine months, remained two separate people, mostly, had days when we didn’t talk, days when we’d find something to agree on, but usually something inconsequential. And days when I’d do something like cook her the noodle dish and wonder again what would become of us.

  So the pregnancy, Lily, was my idea. And birth killed her, killed Mel. I couldn’t face the fact that our relationship might end, and the last thing I made us try to fix it killed her.

  Oh, god, Ash says, and cries again, wiping another dirty mark onto a tissue. You can’t look at it that way.

  And usually I don’t. But sometimes I find myself looking at it that way, and I’m not going to pretend I don’t. See? See what happens when I speak my mind? See what happens when I actually tell someone the worst five per cent of what I feel? And then I had Lily to look after. The most dependent being imaginable. And I had this idea in my head that she’d lost one parent far too easily, and I thought, what happens to her if something happens to me? I was afraid for her, as if she was already halfway to being abandoned. That’s dumb, I know, but it’s how it felt. And that’s when I decided I had to live. Take all possible measures, and do whatever I could for her.