Then again, to me: ‘Look, I told you to clear off.’
‘I am the night sister.’
‘I don’t care if you’re the Queen of bloody Sheba! Get out of the way. I want to get a tracheal tube down him.’
I was pushed aside, and one of the young doctors tried to insert the catheter into the lungs. It is not an easy thing to do, and he had to make several attempts.
‘Arch the neck. It will go down easier. More than that, pull the head backwards; you’ve got to locate the trachea. It’s no good if the thing goes into his oesophagus. We don’t want to oxygenate his guts.’ He laughed at his own joke, and the others laughed in unison.
‘Have you no respect for the dead?’ I bleated, despairingly.
‘He’s not dead, you stupid cow. He’s coming round. This has been highly successful.’
There was nothing I could do. I covered my face with my hands to hide my tears and fled to the office. The nurse whom I had left sitting with Dr Hyem only half an hour earlier came in.
‘Are you all right, Sister? You look dreadful. Can I get you a cup of tea?’
I couldn’t look up. ‘What happened?’ I moaned. ‘How did this happen?’
‘I was sitting with him, like you said, Sister, and he stopped breathing, and I couldn’t feel a pulse, and I didn’t know what to do, so I rang the emergency button.’
That was all that was needed. A young, inexperienced nurse, seeing death, possibly for the first time, and quite possibly frightened at being alone, and me, her senior, unavailable. So she had pressed the emergency button, and a resuscitation team arrived. Once started, the process could not be reversed. And, as the registrar had proudly stated, it had been highly successful.
LAZARUS
The wound in Dr Hyem’s chest was sutured under local anaesthetic, the broken ribs realigned, and the chest bound, to keep them in place. We then raised him to a semi-recumbent position and changed the bed linen. Oxygen was directly entering his lungs, so his colour was good, and the cardiac machine maintained his heartbeat. Fluid was dripping into his circulation, and drugs were introduced to raise the blood pressure, to stimulate the heart muscles, and to thin the blood; antibiotics, a clot-buster and diuretics completed the cocktail.
The registrar and his team were exhilarated by their success. They had saved a life, and that’s what medicine is all about. Lazarus had been raised from the dead. It was a miracle of modern medicine.
The team prepared to leave, all of them exhausted. By then it was 3 a.m., but adrenalin had been pumping through their bodies and now they were worn out. The registrar apologised for his rudeness. ‘It’s the tension that gets me,’ he said. ‘I’m not aware of it. I snap at everyone, they tell me.’ He left with instructions about monitoring the cardiac, pulmonary and blood pressure responses to the machines, and the adjustments that should be made in the event of physical changes.
Dr Hyem breathed quietly all night. His pulse and blood pressure were steady. The drip dripped, the oxygen hissed, the cardiac machine hummed quietly, and the twenty or more men who had been awake during the commotion of the night fell asleep as dawn was breaking.
I had many other duties to attend to in the hospital, but stayed with Dr Hyem as much as possible, and, as I looked at him breathing quietly, I began to feel ashamed of myself. He was alive. Why should I have wished the old man dead? It was unworthy of me; wicked even. He was alive due to the miracles of modern medicine. Nearly twenty years had passed since I had started nursing and everything had changed, scientific advances in drugs, surgery, in technology. I was old-fashioned, I told myself, and must embrace these changes.
At 6 a.m. I started my morning round of the hospital. It was still dark, but the return of day could be felt in the air – sleepy sparrows began to chirp, an early morning milk delivery could be heard in the streets, the first kitchen workers were arriving. As I finished my round, light was returning, and the fears of the night, enshrined in all our fairy tales, were receding. Had the darkness played its part in exaggerating the terror I had felt for Dr Hyem, I wondered?
By about 7 o’clock I had finished the morning round and was able to return to Dr Hyem. The registrar was there before me, checking the dials and drips, listening carefully to his patient’s heartbeat and lungs, taking a sample of blood for path lab investigations.
‘I owe you an apology.’ I said, ‘I doubted you.’
‘No, no, not at all. It can be pretty scary, but as you can see, it can be successful.’ He held out his hand towards Dr Hyem, who looked peaceful. ‘Not every attempt turns out as good as this one. In fact, if I’m honest, most fail. But it’s worth having a go, just to get a result like this.’
He continued with his checks and adjustments, saying as he did so, ‘New techniques for resuscitation are being pioneered in America. Some of our teaching hospitals are using them. Statistically, they are more effective. I would like to try them myself, but we don’t have the equipment here in this backwater.’
He’s a good man, I thought, and a dedicated doctor. He can’t have had more than a couple of hours’ sleep, but still he felt the need to see his patient before starting the day’s routine.
He patted Dr Hyem’s hand. ‘Well, you’re doing nicely, Dad. I’m pleased with you. We’ll have you running around again in a few days. I’m off to get some breakfast now, and I’ll come in and see you later in the day.’
As he left he said, ‘I’ve got a morning in theatre. Tell Sister Tovey I’ll be here around lunchtime.’ Then to Dr Hyem, ‘Doing nicely. You’re doing well. Keep it up.’
Such energy, such confidence, is invigorating.
Sister Tovey, the ward sister, to whom I gave the night report, felt differently. She was a woman about twenty years my senior and was nearing retirement. She had been nursing throughout the war, with two years spent in Egypt, receiving casualties from the fighting in North Africa, a great many of whom died for want of adequate medical attention. She was a woman of vast experience and few words.
‘Dr Hyem told me he wanted no resuscitation,’ she said.
‘He told me that also.’
‘And he told the cardiologist. I know, because I was there at the time.’
‘It must be recorded on his notes, then.’
Together we looked, and there, written quite clearly on about the fourth or fifth page, were the words, ‘In the event of cardiac arrest, do not resuscitate.’
‘I suppose they didn’t see that,’ I muttered.
‘More likely didn’t look! These resuscitations have to be carried out at lightning speed. There’s no time even to think. Just get on with it, that’s the message. I don’t like it. Not a bit.’
‘Well, he’s alive,’ I said.
‘What for?’ she demanded.
The question seemed callous. But was it? Or was it realistic? My first doubts, momentarily dispelled by the registrar’s breezy confidence, returned. I did not reply.
‘What for, I say? Congestive heart failure? Renal failure? Liver failure? I must speak to the cardiologist about this. I don’t like it.’
‘Well, he seems to have recovered and his condition is stable. There is nothing more I can say or do. I’m worn out. I must go home and get the children off to school. Then I must go to bed.’
We parted, and my mind was in turmoil as I drove home. The events of the night were screaming in my poor tired brain. Had it been a triumph, or a tragedy? The registrar’s confidence and Sister Tovey’s doubts were struggling with each other. That dreadful cry, like all the ghosts and ghouls of Hell, kept sounding in my ears. But it was probably not a conscious cry, I told myself, just the involuntary emission of residual air in the lower lungs escaping through slack vocal cords. He was alive, and his condition stable, that was the main thing. One should not drive after a night like that, when the mind is in such a state. It was surprising I did not have an accident.