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‘We need a full history,’ Annie called after Geoff, who was heading to register the patient at Reception. ‘Tell whoever’s on Reception to drop everything, that we need it urgently. Do you want an anesthetist?’ she asked Jackie.
‘Let’s get the history first,’ Jackie said. ‘I don’t want to intubate him if it turns out he’s not for resuscitation.’
‘One other thing.’ Eric, the second paramedic, was sweating with the exertion of holding the arm still as Jackie shot in more drugs. ‘The wife says that his son’s a doctor here. This is Ivan Kolovsky… you know, the fashion designer?’
Jackie’s eyes met Annie’s just as Beth breezed in. ‘Need a hand?’
‘Where’s Iosef?’ Jackie asked, adding more medication to an IV flask as Annie suctioned Ivan’s airway. His eyes had rolled back in his head, his body exhausted from seizing for so long.
‘On his way. He was just talking to the thoracics. Why?’
‘Meet Mr Kolovsky!’ Jackie said with a dry edge. ‘Annie, you go and tell Iosef what’s happening—preferably before he walks in here. Beth—give me a hand.’
Clearly Iosef hadn’t hung around to make small talk with the thoracics because as Annie sped out of Emergency, hoping to meet him in the corridor and forewarn him, they practically collided at the glass automatic doors.
‘Iosef...’ Annie called as he marched past without even a cursory glance. ‘Can I have a word?’
‘I’m busy.’ He didn’t even turn his head to call it over his shoulder.
‘I need to talk to you!’ she snapped loudly, angry that he made everything so difficult, angry that he was so rude, and nervous at what she had to tell him!
‘Well, make it quick. I have a lot of work.’
He just stood there—stood there right in the middle of the corridor, didn’t move near a wall, didn’t duck into a quieter area, didn’t do a single thing to make it easier—just tapped his well-shod foot impatiently as Annie took a deep breath. ‘Could we go somewhere a bit more private?’
‘Why?’ He frowned.
‘Because I need to discuss a patient with you.’ Her cheeks were burning under his scrutiny and out of the comer of her eye and behind his shoulder she could see a rather glamorous mob spilling into Reception, who had to be related to him! ‘And I don’t think the corridor’s a very appropriate place.’
He gave her a thoroughly bored, thoroughly superior look as if to say there was nothing she could possibly tell him that he didn’t already know, but at least he did take a few sideways steps into the IV cupboard and stood there shrugged up against the wall as Annie closed the door and flicked on the light.
‘Your father’s just been brought in.’ Direct and straight to the point she gave him the news and equally as direct and straight to the point he asked her a question.
‘Is he dead?’
‘No, but he’s convulsing and we’re having a lot of trouble stopping that.’ She watched his face for a reaction, but it was utterly unreadable, and in all her years of nursing, all the times she’d broken bad news or difficult news oranysort of news, never, not even once, had anyone shown so little response—not a single flick of his eyes, not one tense swallow. Annie could only liken it to dashing to the shops at six p.m. and finding a ‘Closed’ sign on the door, not a ‘Back in five’ sign, not even ‘Back tomorrow’. Peering into the windows of his soul, all she could see was nothing, just nothing, as if every shelf had been stripped bare.
‘Thank you.’
He didn’t ask for more information, didn’t ask anything of her, just turned and opened the door and headed for Resus. Annie followed him, the rather breathless anesthetist arriving a second after them, but Iosef took immediate control.
‘He is not to be intubated. He is a terminal patient and for palliative care only.’
‘We’re just waiting on his notes.’
‘His notes are at the private hospital,’ Iosef responded, picking up a wall phone and tapping in a number. ‘I will get his oncologist to speak with you now.’
‘Thanks.’ Jackie gave a grateful nod. It was excruciatingly hard dealing with a colleague’s relative, especially one so sick, and it would be far easier to go through his history and prognosis with his doctor rather than his son.
‘He’s stopped seizing,’ Annie said.
The tiny spasms in his hands, the flickering of his eyelids, had all ceased now and Ivan fell into a heavy postictal state, his exhausted body dragging in air.
Jackie spoke to Iosef. ‘His stats are dire and his respiration rate is dangerously low.’
‘I can see that.’ He flicked a light in his father’s eyes, examining him carefully, and it could have been any other patient except that he spoke to the unconscious man in Russian, checking his reflexes before replacing the blanket. The only time his shoulders tensed, the only time she saw his jaw clench was when the family was ushered in, the receptionist apologetically introducing Nina Kolovsky whose loud, throaty sobs filled the room.
‘I asked if she’d wait in the interview room,’ Kath, the receptionist, said to Jackie as Nina’s knees buckled at the sight of her husband. ‘She insisted that she be with him.’
