Dead Man's Grip

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.