by Peter James
‘You know, Phil,’ she said. ‘It’s strange, but I haven’t been to a road fatality in almost two years.’
He unscrewed the cap from a bottle of water. ‘Stay with this job long enough and you will. In time you get everything.’
‘You’ve never had to deliver a baby.’
He smiled sardonically at her. ‘One day—’
He was interrupted by the high-pitched whup-whup-whup siren inside the ambulance. It was a sound that could dement you sometimes, especially during the quiet of the night. The sound of a call-out.
Instantly he looked down at the screen mounted between their seats and read the Incident Review information:
Emergency Inc: 00521. CatB Emergency
Portland Road, Hove.
Gender unknown.
Three vehicle RTC. Bicycle involved.
He tapped the button to acknowledge the call. It automatically loaded the address into the satnav system.
The target response time for a CatB was eighteen minutes – ten minutes longer than for a CatA, but it still called for emergency action. Vicky started the engine, switched on the blue lights and siren, and pushed her way carefully out over a red traffic light. She turned right and accelerated up the hill, past St Nicholas’s Church, pulling out into the right-hand lane and forcing oncoming traffic to brake. She switched between the four different tones of the ambulance’s sirens to get maximum attention from the vehicles and pedestrians ahead.
Moments later, peering hard at the incident screen, Phil updated her. ‘Situation confused,’ he read out. ‘Several calls. Upgraded to CatA. A car crashed into a shop. Oh shit, cyclist in collision with a lorry. Control not sure of situation, backup requested.’
He leaned through the bulkhead for his fluorescent jacket and Vicky felt a tightening in her gullet.
Screaming down towards the clogged-up Seven Dials roundabout, concentrating hard on her driving, she said nothing. A taxi driver sensibly pulled over on to the pavement to let them through. Fuck me, Phil thought, a cabbie who was actually awake! He unclipped his seat belt, hoping Vicky didn’t choose this moment to crash, and began wriggling into his jacket. At the same time he continued watching the screen keenly.
‘Age unknown, gender unknown,’ he updated her. ‘Breathing status unknown. Unknown number of patients involved. Oh shit – high mechanism. SIMCAS en route.’
That meant the Accident and Emergency doctor had been summoned from the hospital to the scene.
Which meant the status of the incident was worsening by the minute.
That was confirmed by the next update on the screen. ‘Limb amputation,’ Phil read out. ‘Ouch! Bad day for someone.’ Then he turned to her and said, ‘Sounds like you might be getting your wish.’
9
Hospitals gave Roy Grace the heebie-jeebies and particularly this one. The Royal Sussex County Hospital was where both his parents, at a few years’ interval, had spent most of the last days of their life. His father had died first, at just fifty-five, from bowel cancer. Two years later, when she was only fifty-six, his mother had succumbed to secondaries following breast cancer.
The front façade, a grand Victorian neoclassical edifice with an ugly black metal and glass portico, used to give him the impression of an asylum whose portals you entered once, never to leave.
Stretching out beside it, and up the hill behind the front entrance, was a massive, messy complex of buildings, new and old, low- and high-rise, joined by a seemingly never-ending labyrinth of corridors.
His stomach knotted, he drove his unmarked silver police Ford Focus estate up the hill to the east of the complex and turned into the small parking and turning area for ambulances. Strictly speaking, this area was for emergency vehicles and taxis only, but at this moment he did not care. He pulled the car up to one side, where he wasn’t causing an obstruction, and climbed out into the rain.
He used to pray as a child, but since his late teens Roy had never had any religious convictions. But he found himself praying now, silently, that his darling Cleo and their unborn child were OK.
He ran past a couple of ambulances backed up to the entrance to Accident and Emergency, nodding greetings to a paramedic he knew who was standing beside a NO SMOKING IN HOSPITAL GROUNDS sign, grabbing a cigarette under the awning. Then, bypassing the public entrance, he went in via the paramedics’ emergency doors.
Early in the day it was always quiet in here, in his experience. He saw a youth sitting in a chair, in handcuffs, a thick bandage on his forehead. A woman police officer stood by him, chatting to a nurse. A long-haired man, his face the colour of alabaster, lay on a trolley, staring vacantly at the ceiling. A teenage girl sat on a chair, crying. There was a strong hospital smell of disinfectant and floor polish. Two more paramedics he knew wheeled an empty trolley out past him.
He hurried along to the admittance desk, behind which were several harassed-looking people, most on them on phones, urgently reading forms or tapping at computer terminals. A male orderly with a thin fuzz of blond hair and wearing blue scrubs, was writing on a large whiteboard on the wall. Grace leaned over the desk, desperately trying to catch someone’s attention.
After an agonizingly long minute the orderly turned to him.
Grace flashed his warrant card, not caring that he was on a personal matter. ‘I think you’ve just admitted Cleo Morey?’
‘Cleo Morey?’ The man looked down at a list, then at the whiteboard on the wall. ‘Yes, she’s here.’
‘How do I find her?’
‘She’s been taken to the labour ward. Do you know your way around here?’
‘A little.’
‘Thomas Kent Tower.’ He pointed. ‘Down there and follow the signs – they’ll take you to the lift.’
Grace thanked him and ran along the corridor, following it left, then right, passing a sign that read X-RAY & ULTRASOUND. ALL OTHER BUILDINGS. He stopped for a moment and pulled his phone out of his pocket, his heart a lead weight in his chest, his shoes feeling like they had glue on them. It was 9.15 a.m. He dialled his boss, ACC Rigg, to warn him he would be late for his 10 a.m. meeting. Rigg’s MSA – his Management Support Assistant – answered and told him not to worry, the ACC had a clear morning.
He passed a WRVS Coffee Shop, then ran on along a corridor lined with a mural of swimming fish, following more signs, then reached two lifts with a parked mobility scooter near them. He stabbed the button for a lift, debating whether to take the stairs, but the doors opened and he stepped in.
It climbed agonizingly slowly, so slowly he wasn’t even sure if it was moving. Finally he stepped out, his heart in his mouth, and opened a door directly in front of him labelled LABOUR WARD. He went through into a bright reception area filled with rows of pink and lilac chairs. There was a fine view out from its windows across the rooftops of Kemp Town and down to the sea. A photocopier sat in one corner and in another there were several food and drink vending machines. Racks full of leaflets had been fixed to the walls. On a modern television screen was the gaily coloured word KIDDICARE.
A pleasant-looking woman in a blue smock sat behind the large reception counter. ‘Ah yes, Detective Superintendent Grace. They phoned from downstairs to say you were on your way.’ She pointed along a corridor with yellow walls. ‘She’s in Room 7. Fourth door on the left.’
Grace was too churned up to say anything beyond a mumbled thank you.
10
The traffic ahead of them was braking and further along Portland Road Vicky Donoghue could see that it had come to a complete halt in both directions. Phil Davidson pulled on his surgical gloves, mentally preparing himself for the task ahead.
A lorry was facing them, the driver’s door open, and several people were gathered towards its rear offside. On the other side of the road a black Audi convertible had ploughed into the side of a café. The driver’s door of that was open, too, and a woman was standing near it, looking dazed. There was no sign of any other emergency vehicles here yet.
She raced the ambulance past the line of vehicles, on the wrong side of the road, keeping her eyes peeled for anyone who hadn’t heard them coming. Then she braked, slowing to a crawl, killing the siren, and halted in front of the lorry. Her stomach tightened and her mouth felt suddenly dry.
The digital display read six minutes, twenty seconds – the length of time taken to get here from when the call came in. Comfortably inside the CatA eight-minute target. That was some small relief. Phil Davidson switched the emergency lights to stationary mode. Before jumping down from the vehicle, both of them briefly absorbed the scene.
The woman standing near the Audi, who had wavy blonde hair and was wearing a smart raincoat, was holding a mobile phone some distance away from her head, as if it was a ball she was about to throw to a batsman. Smashed and upturned tables and chairs lay around the car, but there was no immediate sign of any casualties there, and no one, apart from a youth in a cagoule, who was photographing the scene with his mobile phone, seemed to be taking any notice. The concentration seemed to be around the rear wheels of the lorry.
The two paramedics climbed out, looking around carefully, continuing to take in as much as they could and making sure there was no danger from any passing traffic. But everything had very definitely stopped.
A short, stubby man in his mid-forties, in jeans and overalls, holding a mobile phone, hurried towards them. From his pallid face, wide staring eyes and quavering voice, Vicky could see he was in shock.
‘Under my lorry,’ he said. ‘He’s under my lorry.’ He turned and pointed.
Vicky noticed, a short distance further along, a bicycle lamp, a saddle and a reflector lying in the road. Then, near them, was what looked at first like a length of denim tubing with a trainer attached. Her gullet constricted and she felt a rush of bile, which she swallowed back down. She and Phil hurried through the rain towards the rear of the sixteen-wheel articulated lorry, gently edging back the crowd to give them space.
A young woman was kneeling under the truck, but moved out the way for them. ‘He has a pulse,’ she said.
Nodding thanks, both paramedics knelt down and peered under the vehicle.
The light was poor. There was a stench of vomit from somewhere nearby, mixed with the smells of engine oil and hot metal, but there was something else too, that sour, coppery tang of blood that always reminded Phil Davidson of going into butcher’s shops with his mother, when he was a kid.
Vicky saw a young man with short, dark hair streaked with blood and a lacerated face, his body contorted. His eyes were closed. He was wearing a ripped anorak and jeans, and one leg was wrapped around the wheel arch. The other was just a stump of white bone above the knee surrounded by jagged denim.
The anorak and layers of T-shirt around his midriff were ripped open and a coil of his intestines lay in a pool of fluid on the road.
Followed by her colleague, Vicky, who was smaller, crawled forward, beneath the lorry, smelling oil and rubber, and seized the young man’s wrist, feeling for a pulse. There was a very faint one. The two paramedics were getting covered in oil, road grime and blood, which was soaking into their trousers and elbows and coating their gloves, turning them from blue surgical coverings into bloody, grimy gauntlets.
‘Fubar Bundy,’ Phil Davidson whispered grimly.
She nodded, swallowing acrid bile. It was a term she had heard before, at the fatal accident she had attended previously, only a short distance from this location. The gallows humour of the paramedics – one of their mental survival mechanisms for coping with horrific sights. It stood for: Fucked Up Beyond All Recovery But Unfortunately Not Dead Yet.
With internal organs exposed and on the tarmac, there was very little chance of the victim’s survival. Even if they got him to hospital still technically alive, infections would finish him off. She turned to her more experienced colleague for his guidance.
‘Pulse?’ he asked.
‘Faint radial,’ she replied. A radial pulse meant that he had enough blood pressure to maintain some of his organs.
‘Stay and play,’ he mouthed back, knowing they had no option, as they couldn’t move him because his leg was trapped in the wheel. ‘I’ll get the kit.’
Stay and play was one step above Scoop and run. It meant that although the victim’s chances were slim, they would do all they could – try their best until he was dead and they could stop. Going through the motions, if nothing else.
She was aware of the scream of an approaching siren getting louder. Then she heard Phil radioing for the fire brigade to bring lifting gear. She squeezed the young man’s hand. ‘Hang on in,’ she said. ‘Can you hear me? What’s your name?’
There was no response. The pulse was weakening. The siren was getting louder still. She looked at the stump of his severed leg. Almost no blood. That was the only positive at this moment. Human bodies were good at dealing with trauma. Capillaries shut down. It was like the accident she had attended two years ago, when one of the young lads was dying but was hardly bleeding at all. The body goes into shock. If they could get a tourniquet applied, and if she was careful with his intestines, then maybe there was a chance.
She kept her fingers pressed hard on his radial artery. It was weakening by the second.
‘Hang in there,’ she said. ‘Just hang in there.’ She looked at his face. He was a good-looking kid. But he was turning increasingly paler by the second. ‘Please stay with me. You’re going to be OK.’
The pulse was continuing to weaken.
She moved her fingers, desperately searching for a beat. ‘You can make it,’ she whispered. ‘You can! Go for it! Go on, go for it!’
It was personal now.
For Phil he might be a Fubar Bundy, but for her he was a challenge. She wanted to visit him in hospital in two weeks’ time and see him sitting up, surrounded by cards and flowers. ‘Come on!’ she urged, glancing up at the dark underbelly of the lorry, at the mud-encrusted wheel arch, at the grimy girders of the chassis. ‘Hang on in there!’
Phil was crawling back under the lorry with his red bag and his critical haemorrhage kit. Between them, they covered everything that modern medical technology could throw at a trauma victim. But even as Phil tugged the red bag open, displaying pockets filled with vials of life-saving drugs, apparatus and monitoring equipment, Vicky realized, in this particular situation, it was mere cosmetics. Window-dressing.
The young man’s pulse was barely detectable now.
She heard the whine of the EZ-10 bone drill, the fastest way to get the emergency cannula in. Every second was critical. She assisted Phil, locating the bone inside the flesh of the good leg, just below the knee, the professional in her kicking in, pushing all emotion aside. They had to keep trying. They would keep trying.
‘Stay with us!’ she urged.
It was clear that the poor young man had been dragged right around the wheel arch after the wheel had gone over his midriff, crushing him and splitting him open. Phil Davidson was calculating the likely damage to his internal organs and bones as he worked. It looked as if one of the wheels had shattered his pelvis, which in itself was usually sufficient to cause massive internal bleeding and almost certain death – on top of everything else that was probably going on in there.
This lad’s best hope, he thought grimly as he worked on, would be to die quickly.
11
Roy Grace was shocked to see how pale Cleo looked. She lay in a high bed, in a room with pale blue walls that was cluttered with electrical sockets and apparatus. A tall man in his early thirties, with short, thinning brown hair, dressed in blue medical pyjamas and plimsolls, was standing beside her, writing a measurement on a graph on his pad as Roy entered.
She was wearing a blue hospital gown, and her blonde hair, cascading round her face, had lost some of its usual lustre. She gave Roy a wan, hesitant smile, as if she was happy he had come, but at the same time embarrassed that he was seeing her like this. A forest of electrode pads were attached to her chest and a monitor,
like a thimble, covered her thumb.
‘I’m sorry,’ she said meekly, as he took her free hand and squeezed it. She gave him a weak squeeze back.
He felt a terrible panic rising inside him. Had she lost the baby? The man turned towards him. Grace could see from his badge that he was a registrar.
‘You are this lady’s husband?’
‘Fiancé.’ He was so choked he could barely get the word out. ‘Roy Grace.’
‘Ah, yes, of course.’ The registrar glanced down at her engagement ring. ‘Well, Mr Grace, Cleo is all right, but she’s lost a lot of blood.’
‘What’s happened?’ he asked.
Cleo’s voice was weak as she explained, ‘I’d just got to work – I was about to start preparing a body for post-mortem and I suddenly started bleeding, really heavily, as if something had exploded inside me. I thought I was losing the baby. Then I felt terrible pain, like cramps in my stomach – and the next thing I remember I was lying on the floor with Darren standing over me. He put me in his car and drove me here.’
Darren was her assistant in the mortuary.
Grace stared at Cleo, relief mingled with uncertainty. ‘And the baby?’ His eyes shot to the registrar.
‘Cleo’s just had an ultrasound scan,’ he replied. ‘She has a condition that’s called placenta praevia. Her placenta is abnormally low down.’
‘What – what does that mean – in terms of our baby?’ Grace asked, filled with dread.
‘There are complications, but your baby is fine at the moment,’ the registrar said, pleasantly enough but with foreboding in his voice. Then he turned towards the door and nodded a greeting.