by Jax Burrows
She wondered when, exactly, she’d turned into the Grinch? She used to love Christmas. But that was when Jade was a baby and didn’t really know what was going on. Now, she was a little smarty-pants and knew too much for her age. She knew how to get around her father, that was for sure. And Casey had a habit of spoiling her.
Christmas was becoming just another source of stress. Didn’t she have enough of that already?
*
Lexi was working in Resus, and Casey was Team Leader. About an hour into their shift, a patient was brought in who made Lexi’s heart break. She would rather face all the drunks, student Halloween parties and battered women in the whole of Leytonsfield than to watch little Mrs Maisie Williamson try to smile bravely at her husband, Walt. Lexi just stood watching helplessly at the bottom of the bed the patient had been transferred to. Maisie clutched Walt’s hand tightly. Even though the paramedics, nurses and the junior doctors had each grabbed a piece of the sheet she was lying on and moved her ever so slowly and gently onto the bed, the emaciated woman had cried out in agony and Walt’s face had crumpled with the grief of watching his wife in so much pain.
‘This is Mrs Williamson, eighty-eight and in the terminal phase of stage four small cell lung carcinoma. She has extensive bone, liver and brain metastases and has suffered a myocardial infarction. She also has suspected pneumonia and pleural effusion.’ As the paramedic gave his report, Lexi moved automatically to Casey’s side. He was staring at the floor with a frown on his face as he listened.
‘The most important thing, apart from her need for increased analgesia, is the DNR order.’
DNR. Do Not Resuscitate. The patient had made the decision not to have CPR in the event of another heart attack. Which meant they could do nothing for her but make her comfortable and stand by and watch her die. Lexi felt like weeping.
‘Okay,’ Casey said when the paramedics had gone. ‘I need a nurse to make sure she is comfortable and has all the morphine she needs. Lexi? Could you find an appropriate cubicle for Mr and Mrs Williamson please?’
‘Of course.’ He started to turn away. ‘Casey?’
‘Yes?’ Lexi had never seen Casey so sombre. She knew how much he hated losing a patient. Even one like Maisie with a terminal disease.
‘Are we going to drain the pleural fluid? And should I fix her up to the ECG? What else can we do for her?’
‘Honestly? Not much. I’m not prepared to inflict more pain on her by doing an invasive drainage and the tumour would just cause her chest cavity to fill up with fluid again in a short time. She’ll need oxygen and I’ll get the SHO to insert a line for the syringe driver. Just make her as comfortable as you can, catheterize her and don’t hesitate to come and get me if you need help.’
‘Okay.’ She watched him walk away, his head down and his shoulders slumped. She knew exactly how he felt.
It was terrible watching the SHO, a young woman called Shirley, who didn’t look old enough to be out of school, and who was fighting back the tears, try to insert the syringe driver on the old lady. Nurses were usually the ones to set them up, but Casey wanted his junior doctors to have experience with all the procedures that were done to his patients. He said that was the only way to learn, but Lexi could tell how nervous she was and wished Casey had let her do it this time.
Maisie had lost so much weight and had obviously been bedridden for so long, she was like a little skeleton. But it was essential she succeeded as the patient would need a constant supply of pain relief and she had lost the ability to swallow tablets. The fluid in her lungs was causing her severe shortness of breath and, although she was calm enough at the moment, could become distressed very quickly. Casey would probably prescribe Midazolam if she became agitated. She would also need an antiemetic to stop the feeling of nausea that she was constantly fighting.
Lexi glanced at Walt, standing watching intently and wringing his hands. She just wanted to hug him and tell him everything was going to be alright. But, of course, it wasn’t. He was losing his beloved wife and it was tearing him apart.
‘Mr Williamson? Can I have a quick word?’
As they stepped outside the cubicle, he gave Lexi his full attention, a look on his face that was a mixture of hope and dread.
‘Mr Williamson-’
‘Walt, please.’
Lexi smiled. ‘Walt. Your wife is very ill, and we are doing our best to make her as comfortable as possible.’
‘I know, and I’m grateful, we both are. She’s been through a lot this year.’
‘So have you I imagine.’
He shook his head and frowned. ‘It doesn’t matter about me. She’s all that matters. I want to be at her side when she passes, like I’ve been for the last seventy years. We were childhood sweethearts. You all know about that order thingy, don’t you?’
‘Yes, of course. Your wife’s wishes are for a natural death. We won’t try to bring her back, I promise.’ Lexi was relieved that Walt understood the implications of Maisie’s condition, but she felt helpless in the face of the man’s bravery and grief. She just wished there was something more she could do. Casey’s words came back to her, that patients deserved a good death as much as a good life and she knew that all her nursing skills would be brought into play over the next few hours, to make little Maisie Williamson as comfortable and calm as she could.
‘I’ll make you a cup of tea. How do you take it?’
‘Milk two sugars. Could you make Maisie one as well? I know she can’t swallow as well as she used to, but she could have sips, couldn’t she? She loves her tea, that one.’ He looked at her hopefully and Lexi nodded.
‘Of course. I’ll put it in a plastic feeding cup and she can have sips.’ It would help to prevent her mouth from becoming uncomfortably dry from the oxygen.
‘She has milk and two sugars as well. We’re two peas in a pod me and Maisie.’
Lexi smiled again and hurried away to the staff kitchen before Walt saw the tears that were welling and threatening to spill down her face.
As she made the tea, Lexi wondered how it would feel to be with the same person for seventy years. According to her admission form, the couple didn’t have children, so it appeared that Walt was truly her other half. The thought of what would happen to the poor man afterwards was unbearable and Lexi tried to banish such thoughts from her mind. Her remit was to look after her patient as best she could. There was nothing she could do for Walt but be around to answer questions or to hold his hand when he broke down, as he invariably would.
But Lexi was wrong. After a long, stressful day, spent checking Maisie’s medication to ensure her pain relief was adequate, making tea for Walt and leaving them alone for brief periods to attend to other patients, the end, when it came, was peaceful.
She had only nipped out of the cubicle to use the bathroom and get herself a bottle of sparkling water, expecting the situation to be the same when she returned. Instead, she found Maisie lying still with her eyes closed and Walt, clutching her hand and talking to her gently. He was telling her how much he loved her and how much she had enriched his life. How she was everything he had ever wanted. A final outpouring of love from a devoted husband.
This was an intensely private moment, but Lexi was rooted to the spot at the entrance to the cubicle. She needed to move away and leave Walt and Maisie alone for one last time.
When she went back, Walt was calm although his eyes were red from crying and he looked exhausted.
‘She’s gone,’ he said.
‘Oh, Walt, I’m so very, very sorry. I wish there was more we could have done.’
‘Can I just sit here for a while? I won’t be in your way?’
‘Of course you can. Stay as long as you like.’
He was still sitting there at Maisie’s side when Lexi went off duty. Nobody had the heart to ask him to leave.
It was a good job it was Friday night, the time she and Jess allowed themselves a bottle of wine when the kids were in bed. She felt like getting roarin
g drunk. Totally off her head. But she knew she wouldn’t, and she also knew that her dreams that night wouldn’t be pleasant ones.
Chapter Twenty-Four
Casey managed to press the doorbell, even though his arms were full of parcels. Presents for everyone and bottles of booze. He thought Lexi would probably need a drink after the day they’d both had. He knew he did. He hoped she would ask him to stay the night, so he could dull the edges of the pain of losing a patient and not have to drive home. Somehow, he doubted it.
She had left before he had got the chance to talk to her. The death of a patient was never easy, no matter how many years of experience a person had. Sometimes patients arrived in A&E DOA – dead on arrival – and then, tragic as it was, the staff didn’t feel so responsible. Then there were the patients that were teetering on the brink and were saved by the quick actions and skill of the medical team. They were the most satisfying cases. Those people were the reason he had become a trauma consultant. And then there was the third type. The ones who, like Maisie, had been admitted to A&E to die and there wasn’t a thing anyone could do about it.
Little Maisie Williamson had been a sweetie: brave, uncomplaining, gentle, one of the old school of patients who were grateful for every little thing that was done for them instead of the younger ones who treated A&E like their own private clinic and complained about everything from the price of chocolate in the vending machine to the unreasonably long wait they had to endure, as if they were in a five-star hotel.
God, he was tired. And crabby. And still shaken from his encounter with Helen. He wondered if he would ever see her again. But the thought of seeing Jade again cheered him up.
‘Casey, I wasn’t expecting you.’ Lexi had dark circles under her eyes and had lost her sparkle. He doubted he looked any better.
‘I wanted to see how you were and to see Jade as well, of course.’ He could hear his daughter’s excited chatter inside the cottage and his spirits lifted.
‘Come in.’ She stepped back and he entered a world of cooking smells, a crackling wood fire, children’s laughter and, the best sight in the world, his little girl running up to him and throwing herself into his arms.
‘Daddy!’
‘Hello gorgeous. I’ve missed you.’ He swept her up in his arms and hugged her wriggling little body to him. Immediately, he felt some of the tension start to drain away.
‘Did you buy me a present?’
‘I sure did. Do you want it now?’ He looked at Lexi with raised eyebrows and she nodded. She was standing watching them and her expression was unreadable.
‘Yeah.’
‘Okay then. Let me see if I can find it.’ He had placed the presents on the floor before he picked Jade up, so he put her down, then made a big show of rummaging through them even though he knew which one was hers; the biggest one, wrapped in pink.
‘Here we go.’ He glanced at Lexi who was still watching him. Something was wrong. This was more than the fact that a patient had died. She was annoyed with him over something. ‘I got you a present too.’ He handed her a box, gift-wrapped by the man on the perfume counter at the department store. ‘I hope you like it.’
‘Thanks.’ She opened it while glancing at Jade opening hers. He rather liked being the bearer of gifts for his girls. It made him feel like a real husband and father. Although technically they weren’t even boyfriend and girlfriend yet. A situation he wanted to change as soon as possible. He’d waited long enough.
‘Christian Dior, wow. That’s expensive. Thanks Casey.’
‘No probs. I’ve got something for Jess and Craig too.’ Right on cue, the two of them emerged from the kitchen.
‘Hello stranger,’ said Jess, ‘did I hear someone mention my name?’
‘Here – catch!’ He lobbed a soft parcel at her, and she caught it deftly. He handed Craig his game and ruffled his hair. ‘That’s for you, pal.’
‘Cool, thanks.’ A boy of few words. Which was probably just as well, as Jade had enough for the both of them.
‘Daddy, you’ve got me a dress.’ She was holding up his gift and examining it closely.
‘Not just any dress, honey, that’s the dress that Sleeping Beauty wears. You know that story, don’t you?’ He knew she did as he had read it to her plenty of times. It was one of her favourite fairy stories which she was happy to hear again and again.
‘Yeah.’
‘Thanks, Casey, that’s kind.’ Lexi was still standing, almost as if she wanted to say something but not knowing how.
‘That’s not all. Have you ever been to a pantomime, Jade?’
‘No.’
‘Would you like to go to one?’
‘I don’t know.’
‘She doesn’t know what they are, Casey,’ Lexi said with a frown. Of course, Lexi wouldn’t have been able to afford to take her. The tickets for the best performances were expensive.
‘It’s like a movie but on the stage.’ Craig spoke from the sofa where he was absorbed in something on his mobile. He looked up briefly then blushed as if he had surprised himself by speaking up.
‘Well, we are going to see Sleeping Beauty at the Opera House in Manchester. And you can dress up for the occasion and wear your very own Sleeping Beauty dress. What do you think of that?’
‘Yeah!’ Jade started jumping around the living room as Jess came back wearing the I heart London T-shirt he had brought for her. He hadn’t noticed her absence as he had been so engrossed in watching his daughter.
‘This is great, Casey, thanks mate.’
‘Glad you like it.’
‘Craig, set another place at the table for Casey, would you? We’re having cottage pie,’ said Jess.
‘Great. I love cottage pie.’
He glanced over at Lexi to see her reaction to this and was glad to see she was talking to Jade and explaining further about pantomimes. He wondered if she’d ever been to one. He’d have to ask her later. There was something else he wanted to ask her too, but he needed to catch her in the right mood, and tonight wasn’t looking favourable.
*
Lexi started to feel better as the evening went on. The meal had been pleasant enough. Jess made a superb cottage pie and Casey finished his first. He declared that he had been starving and Jess promptly took his plate and loaded it with more food. He grinned like a little boy and tucked in again.
Lexi spoke little, preferring to listen to the talk around the table which was easy-going and amusing. She didn’t want to have to deal with anything serious tonight. The image of Maisie and Walt Williamson kept drifting across her inner vision and, instead of pushing it away, she let it drift. They had all done the best they could for Maisie and there was no point in going over old ground. She also knew that she would never forget her.
The evening continued with their usual routine. She and Jess did the washing up while Casey put Jade to bed. Craig had disappeared straight after the meal to his mother’s bedroom so he could have some time alone on his computer before going to bed when Jade was asleep. It was difficult for an eight-year-old boy to share a bedroom with an almost four-year-old girl, but he never complained. Lexi loved him for that.
When Casey came downstairs, Jess went upstairs to enjoy facetime with Billy. She did this nearly every evening now; their relationship was moving forward at an alarming rate. At least, Lexi found it alarming; Jess seemed to find it exhilarating. She had a new spring in her step and a permanent grin on her face. Lexi just hoped it didn’t come crashing down around her ears.
Casey collapsed on the sofa next to Lexi. ‘She’s finally asleep. Too excited about the pantomime to listen to any other story but Sleeping Beauty, and I had the heck of a job convincing her not to sleep in that dress.’
‘Thanks for the tickets. When is it again?’
‘Saturday. It’s the matinee and starts at 2.30 so I promised her we could go to MacDonald’s first. Is that okay with you?’ He glanced at her and she smiled. He was asking her permission after he had told Jade, again. S
he had almost given up on getting him to run things by her first. It was a concept that he completely failed to grasp. But what did it matter? She was too tired and depressed to care tonight.
‘It’s fine,’ she said. ‘Shelley seems happy in her new home. I took her to Nina and Hannah’s and left her cuddling a baby and eating bacon butties. That was on Wednesday.’
‘Yes, Dad told me what a great job you’d done finding her a place. I’ll go and visit tomorrow. I’m on a late, so I’ll have time to call in beforehand.’
‘She’ll be happy to see you. Your dad was very helpful, I appreciated it.’ She sipped tea from her favourite mug and settled back on the sofa.
‘He’s Nina and Hannah’s GP and has treated many of the women they help. It’s one of his pet obsessions, helping women who are victims of domestic abuse.’
‘I’d hardly call it an obsession, Casey, more of a calling.’
‘Dad can get very passionate about the causes he supports.’
‘So that’s where you get it from, then.’
‘Me? Do you think I’m like that?’
‘I think you can be very passionate, Casey, yes.’ Passionate in his work and in his bed. The thought made her want to move nearer to him, put her arms around him and lay her head on his chest. But they needed to talk. She had to ask him. Even though she had made the decision to say nothing, she needed him to be straight with her. If he lied, she wanted to know why. But she couldn’t just blurt it out and had to lead up to it slowly.
‘How was the conference?’
‘It was good. I learned quite a lot.’
‘Great. Then you spent the rest of the time in London?’
‘Not all of it.’
‘Oh? So when did you get back to Leytonsfield?’
‘Thursday. I would have called round straight away, but I didn’t get back until late.’