St Matthew's Passion: A Medical Romance

by Sam Archer

The ambulance car tore through the congested London streets, weaving skilfully among the traffic until the massing flicker of blue lights ahead marked their destination. Fin climbed out of the car and trotted down to the river bank, crossing the cordon. He glanced about. Paramedics aplenty, but no sign of Melissa.

  Shouting to be heard above the cacophony from the circling helicopters overhead, he said to one paramedic who was loading a stretcher into the back of an ambulance: ‘Have you seen Ms Havers? Melissa?’

  The man looked over each of his shoulders in turn. ‘She’s somewhere around here. I saw her a minute ago,’ he yelled back.

  Later Fin would wonder whether it was instinct, sixth sense, or some more mystical force that made him turn and sweep his gaze across the river. He took in the flotsam from the smaller boat, the body of which had by now completely disappeared under the water; the larger vessel, which tilted sideways at a crazy angle, seeming to defy gravity; and the remaining bobbing heads as the divers helped the last stragglers to the bank.

  And he saw her, so far away she seemed halfway to the other side, her head appearing and disappearing beneath the rolling wavelets, holding something bundled and writhing above her. If she made a sound, it was buried under the clattering roar from above.

  Melissa.

  Before his thoughts could catch up with what he was doing, Fin was stripping off his luminous overalls – any protection from the cold that they might afford him would be outweighed by how much they’d slow him down once they were soaked – and, in his shirtsleeves and trousers, he dived into the water.

  He struck out towards where he’d seen Melissa. A strong swimmer, he ground his teeth against the almost paralysing cold and began a rhythmic crawl, putting his legs into the manoeuvre to propel himself forwards. Vaguely he registered one of the police divers ahead of him and off to one side, and he heard snatches of what the man was yelling at him – it sounded like the ship’s going to tip over, get out – but he ignored the warning, ignored the cold, ignored everything but the animal drive within him that was telling him to reach Melissa in time, and at all costs.

  Fatigue was beginning to claw at him when he surged upwards to get a better view and saw Melissa’s upturned face twenty yards ahead. It disappeared again under the waves. Still her hands held the bundle aloft, and Fin could see now that it was a child of about three years, its face contorted in distress. That was good: it meant the child was alive.

  Fin closed the distance. Ten yards. Five.

  And he was at her, treading water, his arms enfolding her and hauling her vertically up so that her face appeared inches from his. Her eyes swam vacantly beneath thrumming lids and her mouth was agape and sucking greedily at the air.

  Fin wrapped one arm around her waist, holding her tightly so that her head didn’t slip under again. With his other arm he gently hooked the child free from her grasp and draped its tiny frame across one shoulder, ignoring its pitiful, mewling cries.

  Now came the difficult part.

  With his free arm, the one that wasn’t clutching Melissa close so that the child was held in place between them across his shoulder, Fin began an awkward half-crawl, putting as much power as he could into his legs to make up for the handicap to his upper body. By pulling them forwards with the arm he turned them slightly in the process and had to swing his body to correct their direction each time. Despite the cold, everything about him burned: his shoulder muscles, his legs, the ragged breath in his chest.

  Ignore it. Focus on what’s important, he told himself. One second at a time. Get through that. Then the next second.

  Up ahead, between him and the impossibly distant bank of the river, he saw through the sheets of waves rising and falling at his eye level a police speedboat. Instead of approaching directly it veered sideways. The policemen on board were gesturing and shouting, but he couldn’t make out any distinct words.

  Why aren’t they heading straight towards us to pick us up? thought Fin.

  As before, when the police diver had been trying to communicate with him, he heard the odd word break through the deafening ambient noise of the surging water and the motors of the boats and helicopters.

  Tipping... out the way... hurry...

  As Melissa and the child weighed heavily on his shoulder and he felt the beginnings of cramp in his legs, Fin tried to focus on the men in the speedboat, tried to grasp what exactly they were getting at. They seemed to be staring at a point above and behind him.

  Fin didn’t want to waste time and especially effort looking behind him, but he gave in to the inevitable and kicked his legs so that he twisted jerkily through ninety degrees in the water, his two charges clutched tightly to him. The move enabled him to see what the men had been gesturing at.

  He was struck by not so much terror as awe.

  The larger boat was toppling towards him in slow motion, the damage to its hull having caused it to list sideways in the first place. Now it had passed its centre of gravity and, relentlessly, it was turning on its side. And Fin was directly beneath it.

  Fin’s instinct was to face the towering vessel as it bore down on him. Instead, he kicked himself round to face away from it once more and began to lash the water with his legs and claw at it with his free arm. Something had seized hold of him, a force so primal and terrifying it was like possession by a demon. It was the kind of power that enabled a woman to lift the front of a car in order to free her child trapped beneath it, a property only given to human beings in time of extreme emergency and never to be summoned by force of will alone.

  Dig, kick. Dig, kick. He concentrated on the alternating actions with a manic ferocity, narrowing his consciousness so that everything else was extraneous, unimportant. Through the blur of the water in his eyes he fancied he could see the bank approaching closer with every second, in a series of jerks.

  We’re going to make it, he thought in triumph.

  And the shadow fell across the broken surface of the water before his eyes, cast by the brilliant sun on this clear afternoon. The shadow of the great hull, lengthening as the boat rolled through its final few degrees.

  At the last minute Fin twisted round and looked up, and saw the railing lining the deck of the boat hurtling towards him a second before it struck his head. It was a glancing blow, and would have missed him entirely if he’d been just a few feet ahead; but the impact was terrific, and stunned him so profoundly that when the pain came, a crushing agony like nothing he’d ever experienced before that exploded in his head and lanced down through his neck and torso, he barely registered it.

  The last he was aware of was the fact that Melissa and the child were on the other side of him, and hadn’t been hit by the capsizing boat. Darkness surged over him like thunderclouds across a summer sky, and his consciousness dwindled to a pinpoint before winking out.

  ***

  The ambulance was breaking sixty miles per hour through the crowded inner London streets.

  It wasn’t nearly fast enough.

  Melissa barely felt the juddering of the vehicle’s chassis. She was trembling so violently that the ambulance might as well have been standing still. Wrapped in a thick, custom-designed blanket, she still felt as cold as if she were sitting there naked.

  The paramedics had pushed her gently but firmly to the bench on the other side of the ambulance, where she was now sitting. She’d tried to resist at first, insisting on examining Fin herself; but they’d been adamant.

  ‘You’re in no fit state to be treating anyone, doc. You’ll only make things worse.’

  Melissa had to admit they were right. But as she watched the two paramedics, one woman and one man, busying themselves with Fin, she felt an almost irresistible urge to interfere again.

  She remembered lapsing into a dream-like state out there in the water, pogoing in and out of its sucking depth as she focused on the only thing that mattered: keeping the child above the surface. She’d reached him after what seemed like an impossibly long time and had turned him over in the
water, fearing the worst. His waxy, blue-tinged face had shown no response when she pinched him. Treading water violently, she propped the toddler across her forearm, squeezed his nose shut awkwardly with her other hand, and clamped her mouth over his, breathing out as smoothly and strongly as she could, supplying the air his own tiny body was unable to provide for him.

  She’d breathed twice, three times, breaking off as her flailing legs failed to keep her above water and her head dipped under. With a concentrated effort Melissa reared up again and continued the rescue breaths.

  It was no good. She was too late; the little boy had drowned. And soon she too was going to succumb. Despair tried to force her under the surface once more.

  And without warning, the child had coughed violently and spewed a great gout of river water into Melissa’s face. She’d never been so delighted by something like that in her life.

  He coughed a few more times, and then the yelling started, wonderful piercing screams in her ear as she hugged him close. Her delight and relief soured in seconds. She now had to get them both back to the bank. And she couldn’t do it.

  So she’d focused all her energy on simply not sinking, and keeping the boy’s head above the surface. For it while it had felt as if she could keep up the activity for ever; but before long she’d been aware of the creep of a fatigue more profound than any she’d experienced before, and a greyness began to seep across her consciousness.

  The shock of suddenly being grabbed and borne aloft choked the breath out of her. For an instant, in her confused, half-drowned state, she thought she was being accosted by some malevolent river demon in human form. Then familiarity had clicked into place like the twist of a kaleidoscope.

  It was Fin. He’d come for her, like a guardian angel.

  Try as she might to help him as he hauled her and the squalling toddler against the relentless pull of the water, she’d been unable to muster the strength in her arms and legs and instead had simply lain pressed against Fin, feeling helpless, like dead weight.

  There’d been the confusion of the approaching speedboat and the shouting and then some sort of awful thundering behind them before a great wave had engulfed them, the river making one last concerted effort to drag them under. Then Melissa felt hands prising her free from Fin’s locked arm. She struggled – he’d saved her, and she didn’t want to be wrenched free from his protection – but she was too weak to resist effectively. Once again she felt herself being lifted, this time by several pairs of hands. The next thing she was aware of was the hard surface of the floor of the speedboat.

  Events after that had moved so quickly that she’d registered only a small proportion of them. Fin was strapped to a stretcher on the bank and rolled into the back of a waiting ambulance. He was unconscious, and one of the paramedics had to keep a wad of gauze pressed to his head to stop the bleeding. The child, Melissa noticed, was in his hysterical mother’s arms, crying himself, already wrapped tightly in blankets. He’d have to go to hospital by ambulance as well, but for a few moments the crew indulged mother and son in their reunion.

  Melissa started to clamber aboard the ambulance after Fin. The female paramedic stopped her.

  ‘We need to have a look at you.’

  ‘There’s no time, and you can’t spare the staff,’ Melissa said thickly. Nausea was beginning to kick in. ‘If I’m in the ambulance then at least you can keep an eye on me.’

  The paramedic hesitated, then nodded and helped Melissa into the back.

  After she’d tried to interfere, after the ambulance crew had pushed her away and she’d resigned herself to taking a back seat, she nevertheless kept her eyes fixed on Fin and on the expressions of the two paramedics attending to him. She listened to their reports: his blood pressure and pulse were fine, but his temperature was unsurprisingly low. More worryingly, the oxygen saturation in his blood was below normal, and dropping.

  ‘Pupils equal and reactive,’ muttered one of the paramedics. Then: ‘GCS ten.’

  The paramedics moved aside, having done all they could for now. Melissa stared at Fin’s face. She’d never seen it in repose before. The wryness was gone from the mouth, along with the semi-dimple at its corner. The closed lids hid the keen intelligence, the passion, that normally radiated from the eyes.

  It was a face that, for the first time since Melissa had met him, was at peace.

  The peace, perhaps, of one who had come to the end of his life, and was accepting death with resignation.

  Melissa swept ropes of wet matted hair out of her face and pressed her fist against her teeth, choking back a sob.

  She pleaded with him silently.

  Don’t, Fin.

  Please don’t die.

  And, although she knew it was impossible, she aimed a thought at him that perhaps he might in some odd telepathic way register.

  I love you.

  It was only when both paramedics glanced round sharply at her that Melissa realised she’d spoken out loud.

  Chapter Eleven

  Melissa almost grabbed the films out of Professor Penney’s hands. He’d come ambling down the corridor perusing them, having just collected them in person from the radiology department.

  They were the images from Fin’s MRI scan, the ones that would give an idea of the condition of his brain structure.

  The professor handed them over and Melissa rammed them up into the viewing box, alongside each other. She flicked the switch to illuminate them.

  Beside her Prof Penney peered at them through his glasses. The radiologist had already telephoned through the result but Melissa and the professor, who as trauma surgeons were both skilled at interpreting scans of this type, wanted to see for themselves.

  Fin had already undergone an X-ray of his head, an early investigation that had been performed soon after he’d been wheeled into the ‘majors’ room at the Accident & Emergency department. The bleeding from his head was the result of a scalp wound, a ragged laceration that proved relatively easy to suture closed once it had been cleaned and the tiny blood vessels had been tied off. Melissa had wanted to see to the wound herself but once again had been pushed to one side by the A&E consultant, who’d done the suturing.

  The X-ray revealed no fracture of the skull. Fin was lucky. The boat’s railing had struck him on the crown of the head, where the bone was dense. A few inches lower and to the side, on the thin plate of the temple, and the bone would have been shattered.

  The absence of a bony fracture was only a small piece of good news, however. A bleed might have occurred inside the head as a result of the impact, between the skull and the brain. Worse, there might be a haemorrhage within the brain itself. Fin might end up partially or wholly paralysed, or without the power of speech or swallowing. He might never recover, but rather live on in a PVS, a persistent vegetative state, kept breathing artificially with a ventilator and kept nourished by an assortment of infusions, conscious but utterly unable to communicate with those around him, to interact with the outside world in any way.

  Or - and to Melissa this was the worst possibility, worse even than the notion of Fin’s living the rest of his life shut into himself - he might die.

  Melissa had forced these morbid thoughts out of her head like a gardener scything through knots of malignant weeds, but every time they’d grown back with frightening speed. Realising she was wasting her time, Melissa had focused on the practical. She had sent the order for the MRI scan herself, and while the arrangements were being made for Fin to be transported up to the scanner she’d recognised that she herself needed at least a minimum of attention if she were to stay upright in the hours ahead. So she’d allowed herself to be examined by one of the A&E registrars, and had then gone upstairs to the staff bathrooms and subjected herself to a scalding shower, realising only when she was towelling herself off afterwards just how numbingly, inhumanly cold she had been for the last hour.

  Warmed, and in clothes someone had found for her that fitted approximately, she wandered the corridors
of the hospital, finding it unfamiliar for the first time since she’d arrived, until she saw Professor Penney emerging from the radiology room with the results of Fin’s scan.

  They studied the pictures in silence. The films showed sequential ‘slices’ of Fin’s head, horizontal snapshots of different planes through his brain.

  There were no tell-tale areas of whitening, no indications of fluid accumulating where it didn’t belong.

  Nor were any of the structures distorted, as though some mass were pushing them sideways.

  Melissa and the professor gazed at the pictures for a full five minutes without exchanging a word. Occasionally they stepped around one another to get a better view of the pictures at the other end of the viewing box, or moved closer to put their noses almost against the screen to make sure of something that wasn’t clear from further away.

  At last she glanced sideways at Professor Penney. He returned her look.

  Melissa was the first to speak. ‘Nothing there.’

  He raised his eyebrows and gave a small nod, but the relief in his face was plain, and mirrored hers.

  It meant a non-specific brain injury, then, Melissa thought as she headed back towards the lifts that would take her to the Intensive Care Unit where Fin had been moved after the scan. He was unconscious, was still unresponsive to pain. A gloomy sign. And the neurosurgeon who’d examined him shortly after they’d reached the hospital had commented on the slight blurring of Fin’s optic discs, meaning oedema around the brain. He was being infused with steroids in an attempt to reduce the swelling. There was no tell-tale sign on the MRI scan of oedema, no crowding out of the dips between the convolutions of the brain, but all that meant was that the swelling wasn’t massive or immediately life threatening. The next twenty-four hours would be critical; but even if the intracranial pressure was successfully lowered, there was no telling how long Fin would remain unconscious.

  Or if he’d ever wake up.

  Melissa stepped into the ICU and was struck as always by the unique atmosphere of the place: a layer of tranquillity undershot by a dynamic of suppressed tension and foreboding. It was at once far calmer and quieter than most other, more ‘normal’ wards, and closer to the phenomenon of sudden death. By its very nature it had a limited number of beds, catering as it did for the most critically ill patients in the hospital. The staff bustled quietly, their footsteps and murmured voices accompanied by the rhythmic beeping of countless monitors and the clunky hiss of ventilation machines.