Dead Tomorrow

13

Susan Cooper had discovered that there was a fine view from this particular window, just past the lifts on the seventh floor of the Royal Sussex County Hospital, across the rooftops of Kemp Town to the English Channel. All today, the sea had been a brilliant, sparkling blue, but now, at six o’clock on this late November evening, the falling darkness had turned it into an inky void, stretching to infinity beyond the lights of the city.

She was staring out at that vast blackness now. Her hands rested on the radiator, not for the warmth it gave off but merely to support her drained body. She stared silently, bleakly, through the reflection of her face in the window, feeling the draught of cold air through the thin glass. But feeling little else.

She was numb with shock. She could not believe this was happening.

She made a mental list of the people she still needed to call. She’d dreaded breaking the news to Nat’s brother, to his sister in Australia, to his friends. Both his parents had died in their fifties, his father from a heart attack, his mother from cancer, and Nat used to joke that he would never make old bones. Some joke.

She turned, padded back to the Intensive Care Unit and rang the bell. A nurse let her in. It was warmer in here than out in the corridor. The temperature was maintained at 34- 35°C, high enough for the patients to lie in hospital pyjamas, or naked, without any risk of catching cold. It was an irony, she thought, although she did not dwell on it, that she had once worked as a nurse here, in this very unit. It was in this hospital that she and Nat had met – shortly after he had started as a junior registrar.

She felt movement inside her. The baby was kicking. Their baby. Thirty weeks old. A boy.

As she turned right, walking past the central nursing station, where a prosthetic leg had been abandoned on a chair, she heard the swishing of a curtain being pulled. She looked across at the far corner of the ward and her heart lurched inside her. A nurse was drawing the blue privacy curtain around Bed 14, Nat’s bed. Sealing it from prying eyes. They were about to start some new tests and she wasn’t sure she had the courage to be with him while they did. But she had sat by his side almost all day and she knew she had to be there now. Had to keep talking to him. Had to keep hoping.

He had compound and depressed skull fractures, a lesion to the cervical region of his spinal cord that was likely to leave him a quadriplegic if he survived, as well as an almost irrelevant – at this stage – fractured right clavicle and fractured pelvis.

She hadn’t prayed in years, but she found herself praying repeatedly today, in silence, always the same words: Please, God, don’t let Nat die. Please, God, don’t let him.

She felt so damn useless. All her nursing skills and she could not do a thing. Except talk to him. Talk and talk and talk, waiting for a response that did not come. But maybe now would be different…

She walked back across the shiny floor, passing a hugely fat woman in the bed to her right, the rolls of flesh on her face and body looking like the contours of a 3-D map. One of the nurses told her the woman weighed thirty-nine stone. A sign on the end of the bed said DO NOT FEED.

To her left was a man in his forties, his face the colour of alabaster, intubated, a forest of wires taped to his chest and head. He looked, to her experienced eye, as if he had recently come out of heart-bypass surgery. There was a large, cheery get-well card propped on an instrument table beside him. At least he was on the mend, she thought, with a good chance of walking out of this hospital, rather than being carried out.

Unlike Nat.

Nat had been in steady decline throughout the day and, although she was still clinging to a desperate, increasingly irrational hope, she was starting to sense a terrible inevitability.

Every few minutes her phone, turned to silent, vibrated with yet another message. She had stepped out to reply to some. To her mother. To Nat’s brother, who had been here this morning, wanting an update. To his sister in Sydney. To her best friend, Jane, whom she had called tearfully this morning, an hour after arriving here, telling her that the doctors weren’t sure whether he would live. Others she ignored. She did not want to be distracted, just wanted to be here for Nat, willing him to pull through.

Every few moments she heard the beep-beep-bong of a monitor alarm. She breathed in the smell of sterilizing chemicals, catching the occasional tang of cologne and a faint, background note of warm electrical equipment.

Inside the curtained space, propped up in a bed that had been cranked to a thirty-degree angle, Nat looked like an alien, bandaged and wired, with endotracheal and nasogastric tubes in his mouth and nostrils. He had a probe in his skull to measure intracranial pressure, and another on one finger, and a forest of IV lines and drains from bags suspended from drip stands running into his arms and abdomen. Eyes shut, he lay motionless, surrounded by racks of monitoring and life-support apparatus. Two computer display screens were mounted to his right, and there was a laptop on the trolley at the end of the bed with all his notes and readings on it.

‘Hello, darling,’ she said. ‘I’m back with you.’ She stared at the screens as she spoke.

There was no reaction.

The exit tube from his mouth ended in a small bag, with a tap at the bottom, half filled with a dark fluid. Susan read the labels on the drip lines: Mannitol, Pentastarch, Morphine, Midazolam, Noradrenaline. Keeping him stable. Life support. Preventing him from slipping away, that was all.

The only signs that he was alive were the steady rising and falling of his chest and the blips of light on the monitor screens.

She looked at the drip lines into the back of her husband’s hands, and the blue plastic tag bearing his name, then at the equipment again, seeing some machinery and displays that were unfamiliar. Even in the five years since she had left nursing for a commercial job in the pharmaceutical industry, new technology that she did not recognize had come in.

Nat’s face, a mess of bruises and lacerations, was a ghostly shade of white she had never seen before – he was a fit guy who played a regular game of squash, and normally always had colour in his face despite the long – crazily long – hours of his job. He was strong, tall, with long, fair hair, almost rebelliously long for a doctor, not long past thirty and handsome. So handsome.

She closed her eyes for an instant to stop the tears coming. So damn sodding handsome. Come on, darling. Come on, Nat, you are going to be OK. You are going to get through this. I love you. I love you so much. I need you. Feeling her stomach, she added, We both need you.

She opened her eyes and read the dials on the monitors, the digital displays, the levels, looking for some small sign that could give her hope, and not finding it. His pulse was weak and erratic, his blood oxygen levels way too low, brainwaves scarcely registering on the scale. But surely he was just asleep and would wake up in a moment.

She had been in the hospital since ten this morning, arriving after the phone call from the police. It was another irony that she had been due to come to this same hospital for a scan today. That was why she had still been at home when the phone rang, instead of at Harcourt Pharmaceuticals, where she worked on the team monitoring clinical trials of new drugs.

It had helped that she knew her way around the labyrinth of the hospital’s buildings and also that plenty of people who worked here knew her and Nat, so she wasn’t given the usual platitudes and kept out of the way, but instead got straight talking from the medical team, however unpalatable it was.

By the time she had arrived here, half an hour behind Nat, he was already in the CT unit, having a brain scan. If it had shown a blood clot he would have been transferred to the neurological unit at Hurstwood Park for surgery. But the scan had shown there was massive internal haemorrhaging, which meant there was nothing surgical that could be done. It was a wait and see situation, but it appeared more than likely that he had irreversible brain damage.

The medical team had stabilized him for four hours in A &E, during which time there had been no change in his condition and his total lack of responsiveness persisted.

On the Glasgow Coma Score tests, before he had been sedated, Nat had produced a result of 3 out of a possible 15. He had no eye response to any verbal commands, or to pain, or to pressure applied directly to either eye, giving him the minimal score of 1. He gave no verbal response to any questions or comments or commands, giving him a score of 1 on this verbal part of the test. And he had no response to pain, giving him a score of only 1 in the motor response section. The maximum a person could score was 15. The minimum was 3.

Susan knew what that result meant. A score of 3 was a grim, though not 100 per cent reliable, indicator that Nat was brain dead.

But miracles happened. In her nursing years in this unit, she had known patients with a score of 3 go on to make full recoveries. OK, it was a tiny percentage, but Nat was strong. He could make it.

He would!

The short, friendly Malaysian nurse, Saleha, who had been with Nat one-on-one for the whole afternoon, smiled at Susan. ‘You should go home and get some rest.’

Susan shook her head. ‘I want to keep talking to him. People respond sometimes. I remember seeing it happen.’

‘Does he have favourite music?’ the nurse asked.

‘Snow Patrol,’ she said, and thought for a moment. ‘And the Eagles. He likes those bands.’

‘You could try getting some of their CDs and playing them to him. Have you got an iPod?’

‘At home.’

‘Why don’t you get it? You could get his wash stuff at the same time. Some soap, a facecloth, toothbrush, his shaving stuff, deodorant.’

‘I don’t want to leave him,’ Susan said. ‘In case…’ She shrugged.

‘He’s stable,’ Saleha said. ‘I can call you if I think you should get back here quickly.’

‘He’ll be stable all the time you keep the machines on, won’t he? But what happens when you switch them off?’

There was an awkward silence, during which both women knew the answer. The nurse broke it. She said cheerily, ‘What we have to hope is that there will be some improvement overnight.’

‘Yes,’ Susan said, her voice choking as she tried to hold back the tears.

She stared at Nat’s face, at his motionless eyelids, willing him to move, willing those eyes to open and his lips to smile.

But there was no change.