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After that there was a steady stream of patients and by the time Keely arrived home she was exhausted. So was Zach.
'That,' he said quietly, sinking into a chair in the kitchen, 'was a very bad day. Let's hope the rest of the week is better.'
It wasn't.
In fact, it got worse.
Every time the doors to A and E opened, drama followed, and by the end of the week Keely felt emotionally drained.
Dealing with critically injured patients was bad enough, but for Keely the worst bit was telling the relatives. Telling someone that their loved one had just died was the hardest thing she'd ever had to do.
'How do you do it?' she asked Zach one afternoon after they'd failed to resuscitate a twenty-year-old motorcyclist. 'How do you cope with telling them that their child is dead?'
Zach poured them both a cup of coffee, his face drawn. 'How do I cope? I suppose I switch off. I treat it as a job to be done. But it doesn't mean I don't feel it.'
He did feel it, Keely knew that. She'd seen the strain on his face after a week of repeated tragedy.
'I almost wanted to lie to those parents,' she admitted quietly, staring down at the coffee he handed her. 'The way they looked at me when I walked into the room, I wanted to tell them that there might be hope.'
'I know the feeling,' Zach said gruffly. 'But you mustn't ever do that. As it is, people find it hard to take in bad news. Harsh though it sounds, the only way to do it is to be blunt early on. And don't use euphemisms. Relatives will try very hard to misunderstand you because they don't want to hear the truth. If the patient is dead then you need to use the word "dead" very early on in the conversation and then use it several times. It's kinder in the long run.'
Keely looked at her coffee without enthusiasm. She didn't think her stomach would tolerate anything at the moment.
'Well, I'm seriously hoping not to have to use the word "dead" for a long time,' she said gloomily. 'I've used it enough this week to last me a lifetime. Surely we can't have any more tragedy.'
They did.
It was later in the afternoon when the hotline—the phone that connected straight to Ambulance Control— rang.
Nicky picked it up, listened and made notes, asked a few questions and then replaced the receiver.
'They're bringing in a four-year-old with difficulty breathing,' she told Keely quickly. 'I'll check everything in Resus. Will you make sure you're ready when they arrive?'
The doors to the ambulance bay crashed open only minutes later and the crew hurried in with mother and child.
Keely took one look at the child and turned to Nicky.
'I want the paediatric consultant, the ENT guys and an anaesthetist down here now!'
Quickly they took them into Resus and Keely pushed forward a chair.
'Sit down, Mrs Potter. Keep her on your lap.' She glanced at Nicky. 'Let's keep her with her mother so we don't upset her further, and give her some humidified oxygen, please.'
Zoe, the paediatric staff nurse, reached for the oxygen and placed a mask near the child's face, murmuring soothin
g noises as she did so.
The child looked severely ill, her face pale as she leaned forward on her mother's knee, drooling slightly.
'I need some details from you, Mrs Potter,' Keely said quietly, her eyes never leaving the child as she watched for any change in her condition. 'How long has she been ill?'
'Alice was fine yesterday.' The mother stroked the child's hair. 'I can't believe that she can have got like this so quickly.'
'Has she complained of any pain? Has she been coughing?'
'She said her throat was sore and she stopped eating because she couldn't swallow,' Mrs Potter said, and Keely nodded, her eyes still on little Alice.
The child was ominously quiet and Keely had a very, very bad feeling about her.
