Dead Tomorrow

48

‘Please tell me you are joking?’ Lynn begged.

She was utterly exhausted after the sleepless night she had just spent in the chair beside Caitlin’s bed, in the small, claustrophobic room off the liver ward. A muted cartoon was playing on the small, badly tuned television bolted to an extension arm on the wall above the bed. A tap was dripping in the sink. The room smelled of poached eggs from breakfast trays out in the main ward, weak coffee and disinfectant.

It must have been like the kind of tense, desperate last night a prisoner spends before being executed at dawn, hoping for that last-minute reprieve, she thought.

Lights coming on and off. Constant interruptions. Constant examinations, injections and pills given to Caitlin, and blood and fluid samples being taken from her. The alarm handle dangling from a cord above her. The empty drip stands and the oxygen pump that she did not need.

Caitlin fretting, unable to sleep, telling her over and over again that she was itching and scared, and wanted to go home, and Lynn trying to comfort her. Trying to reassure her that in the morning everything would be fine. That in three weeks she would be leaving the hospital with a brand-new liver. If all went well, she would be home in time for Christmas, OK, not to Winter Cottage, but to the place that was now her home.

It would be the best Christmas ever!

And now this woman was standing in the room. The transplant coordinator. Shirley Linsell, with her English rose face and her long hair, and the tiny burst blood vessel in her left eye. She was wearing the same white blouse and knitted pink top and black trousers as when she had first met her, almost a week – that seemed like a million years – ago.

The only difference was her demeanour. When they had first met, she had seemed positive and friendly. But now, at seven o’clock this morning, although apologetic, she seemed cold and distant. Lynn stood facing her, glaring in fury.

‘I’m extremely sorry,’ she said. ‘I’m afraid these things happen.’

‘Sorry? You phoned me last night to say that you had a liver that was a perfect match, and now you are telling us you were wrong?’

‘We were informed a liver had become available which was a good match.’

‘So what exactly happened?’

The coordinator addressed Lynn, then Caitlin. ‘From the information we were given, it appeared that the liver could be split, with the right side to be given to an adult and the left side to you, Caitlin. When our consultant and his team went down to the hospital to collect the liver, in their assessment, it was healthy and suitable. We use a scale of size of liver against body weight. But this morning our senior consultant surgeon, who was to have performed the transplant, examined the liver more closely and found there was more than 30 per cent fat. He did a biopsy and made a decision that it would not be suitable for you.’

‘I still don’t understand,’ Lynn said. ‘So are you going to throw it away?’

‘No,’ Shirley Linsell said. ‘With this amount of fat, there is a danger it could take several weeks to function properly. Caitlin needs a liver that will function immediately. She is too ill to take the risk. It will be used for a man in his sixties with liver cancer. It will hopefully prolong his life for a few years.’

‘How great is that?’ Lynn said. ‘You’re bumping my daughter in favour of an elderly man? What is he? Some fucking alcoholic?’

‘I can’t discuss another patient with you.’

‘Yes, you can.’ Lynn raised her voice. ‘Oh yes, you damn well can. You’re sending Caitlin home to die so some fucking alcoholic, like that footballer George Best, can live a few more months?’

‘Please, Mrs Beckett – Lynn – it’s not like that at all.’

‘Oh? So what is it like, exactly?’

‘Mum!’ Caitlin said. ‘Listen to her.’

‘I am listening, darling, I’m listening really hard. I just don’t like what I’m hearing.’

‘Everyone here cares for Caitlin, a lot. It’s not just work in this unit – it’s personal for us all. We want to give Caitlin a healthy liver, to give her the best chance of a normal life, Mrs Beckett. There is no point in giving her a liver that might not work or that might fail in a few years’ time and put her through this ordeal a second time. Please believe me – the whole team here wants to help Caitlin. We’re very fond of her.’

‘Fine,’ Lynn said. ‘So when will this healthy liver be available?’

‘I can’t answer that – it depends on a suitable donor.’

‘So we’re back to square one?’

‘Well – yes.’

There was a long silence. ‘Will my daughter be at the top of the priority list?’ Lynn demanded.

‘The list is very complicated. There are a number of factors affecting it.’

Lynn shook her head vigorously. ‘No, Shirley – Nurse Linsell. Not a number of factors, just one as far as I am concerned. My daughter. She needs a transplant urgently – correct?’

‘Yes, she does, and we are working on that. But you have to understand, she is one of many people.’

‘Not to me, she isn’t.’

The woman nodded. ‘Lynn, I appreciate that.’

‘Do you?’ Lynn said. ‘What percentage of patients on your waiting list die before they get a liver?’

‘Mum, stop being so hostile!’

Lynn sat on the side of the bed and cradled Caitlin’s head in her arms. ‘Darling, please let me deal with this.’

‘You’re talking about me like I’m some retard in a box. I’m upset! Don’t you see that? I’m just as upset as you are – more – but it’s not going to help getting angry.’

‘Do you realize what this bitch is saying?’ Lynn exploded. ‘She is sending you home to die!’

‘You are being, like, so dramatic!’

‘I AM NOT BEING DRAMATIC!’ Lynn turned to the coordinator. ‘Tell me when another liver is going to be available.’

‘I’d be misleading you if I gave you a time or a date, Lynn.’

‘Are we talking twenty-four hours? A week? A month?’

Shirley Linsell shrugged and gave a wan smile. ‘I don’t know, that’s the honest truth. We thought we had got lucky, getting this liver so quickly, in a week with no matching recipient higher up the priority list than Caitlin. The donor was an apparently healthy thirty-year-old man, but clearly, it turned out, he had a drink or a diet problem.’

‘So this same shit could happen again, could it?’

The coordinator smiled, trying to placate Lynn and reassure Caitlin. ‘We have a very good record here. I’m sure that everything will be fine.’

‘You have a good record? What does that mean?’ Lynn said.

‘Mum!’ Caitlin implored.

Ignoring her, Lynn went on, ‘You mean you have a good record compared to the national average? That only 19 per cent of your patients die before they get a liver, compared to the national average of 20 per cent? I know about the National Health and your damn statistics.’ Lynn started crying. ‘You’ve gambled with my daughter’s life by giving some elderly alcoholic an extra few months of life because that will tick the right boxes for your statistics. I’m right, aren’t I?’

‘We don’t play God here, Mrs Beckett. We cannot say that one human being has more right to life than another because of their age, or because of how they may or may not have abused their bodies. We’re non-judgemental. We try our best to help everyone. Sometimes we have to make difficult decisions.’

Lynn glared at her. Never in her whole life had she hated anyone as much as she hated this woman right now. She didn’t even know if she was getting the truth or being fed some yarn. Had some rich oligarch with a sick child made a donation to the hospital for bumping Caitlin and getting his child saved? Or had there been a screw-up that she was trying to cover up?

‘Really?’ she sneered. ‘Difficult decisions? Tell me something, Shirley, did you ever lose a night’s sleep in your life over a difficult decision?’

The nurse kept calm, her tone gentle. ‘I care about all our patients very deeply, Mrs Beckett. I take their problems home with me every night.’

Lynn could see she was telling the truth.

‘OK, answer this for me – you just said that Caitlin would have got this liver, had it been OK, because there was no matching recipient higher up the list than her. That could change, right? At any moment?’

‘We have a weekly meeting to decide the priority list,’ Shirley Linsell replied.

‘So it could all change at your next meeting, couldn’t it? If someone in greater need than Caitlin – in your assessment – came along?’

‘Yes, I’m afraid that’s how it works.’

‘That’s great,’ Lynn said, her blood boiling again. ‘You’re like a firing squad, aren’t you? This weekly meeting to decide who is going to live and who’s going to die. It’s like you all pull the trigger, but one of you doesn’t have a bullet in the gun, just a blank. Your patients die and none of you has to take the damn blame.’