‘Gerard?’ Turning with a smile, Madison stared back to where she’d just come from and froze. She stood fixed to the spot. Vaguely aware of the coffee from her cup splashing onto the new blue carpet, followed in a split second by the sound of the cheap, china mug thudding to the ground, the world moved in slow motion for a moment. A tiny, useless croak came from her throat and then she was running, running towards her boss, her friend, her confidant, running as fast as her legs would carry her, as Gerard slowly slid down the length of the glass door, his face in the fluorescent light a hideous purple. Then the world was speeding up again, seemingly stuck on fast-forward, and Madison begged it to slow back down as she reached her boss, broke his leaden fall a touch and lowered Gerard to the floor.
Madison crouched on her knees, willing herself to hold it together, drawing on her professionalism, almost reading off the chart that was tattooed in her mind, through the ABC—airway, breathing, circulation—trying, trying to treat him as a patient, desperate to give back to this amazing, talented man some of what he’d so readily delivered to others in the course of his career.
‘It’s OK, Gerard,’ Madison soothed him, her voice amazingly assured. She checked his airway, watching, praying to see the rise and fall of his chest as her fingers desperately fought to locate a pulse in his neck.
‘Gerard.’ Her voice was sharper now, tears muffling her words as she called out his name, but even as she pinched his nose, tried to keep her breathing even enough to drag in some air to exhale, clamped trembling fingers into position over his chest, Madison knew he had gone, knew in that moment the vital, eloquent, disarming man had already gone for ever.
But that knowledge didn’t stop her from trying to bring him back to them all—to his family that needed him, to his friends and colleagues that adored him, to the department he had created from the first blueprint.
Barely looking up as footsteps thudded towards her, she noted with relief that the new consultant had picked up vital emergency equipment on his way—an ambubag to reinflate Gerard’s lungs and a mini oxygen cylinder, even the red bag that contained a self-administering defibrillator. She moved aside as the man she’d briefly glimpsed ripped open the packages, connected the tubing and took over Gerard’s airway with an ambu-bag. She concentrated instead on cardiac compressions as Vic arrived, shouting into his walkie-talkie for assistance, dragged an oxygen cylinder over and connected it to the bag Guy was squeezing.
‘What happened?’ Guy’s voice was deep but urgent—no introduction, no niceties, because there was nothing nice about this.
‘You saw what happened,’ Madison answered, leaning in as she pummelled Gerard’s chest. ‘He just collapsed.’
‘Did he complain of chest pain?’
‘No.’
‘Headache, dizziness, shortness of breath?’
‘Nothing!’ She almost shouted it. ‘I thought he was walking behind me.’
‘Is there anything else I can do?’ It was Vic speaking now, Vic desperate to help, to do something, anything. ‘I let Switchboard know on my walkie-talkie as I was running over. The nursing supervisor was just pulling up in the car park when it happened, they’re going to send for her.’
‘We need to get him to Resus—get a trolley,’ Guy shouted, but Vic was already picking up Gerard’s shoulders, and Guy assisted him, somehow carrying the leaden weight. Madison raced ahead, turning on machines that had so far only been used in practice runs, completely unable to comprehend that the patient they’d so eagerly anticipated, had so long awaited, had trained and practiced for, had, in fact, turned out to be Gerard himself.
As Madison ripped open chest pads, Guy tore at Gerard’s suit then picked up the chest paddles and placed them over Gerard’s chest to give a reading of his heart rate.
‘Asystole,’ Madison said, seeing the flat line appear on the monitor. She plugged in the ambu-bag to the walled oxygen and commenced the breathing for Gerard, but Guy shook his head.
‘It could be fine VF,’ he said, hoping that the reading that was showing on the monitor wasn’t a true one—asystole was the worse kind of cardiac arrest, but there was a chance, a tiny one, that his heart was fibrillating and that the reading was so fine the machine couldn’t pick it up, a tiny chance that he had a type of cardiac arrhythmia that could be reverted and Madison stood back as Guy gave Gerard the benefit of the doubt and delivered a shock to his lifeless body.
‘Still asystole.’ Guy’s voice was hoarse. ‘Keep up the massage.’ They needed more hands, needed help here now, and thankfully it arrived. Shirley, the nursing supervisor, racing into Resus, her expression appalled when she took in the scene.
‘Bag him, Shirley,’ Madison ordered, clipping a tourniquet to Gerard’s flaccid arm and getting IV access as Guy continued to pound Guy’s chest. ‘Vic, call for an ambulance, tell them we need the MICA.’
‘MICA?’ Vic gave a panicked, bewildered shake of his head.
‘The mobile intensive care unit, Switch will understand. Tell them to say that our doctor has had a cardiac arrest and we need him to be transferred, we need an ICU bed…’ Madison was pulling up the standard drugs used during a cardiac arrest and handing them to Guy, before he even had to name them. She winced as he shocked Gerard again, the horrible, singed smell filling the sterile room. She felt the indignity of seeing the immaculate Gerard with his chest bared, his tie cut and pushed to the side. But as was so much the man, a handkerchief still peeped out of his suit pocket—a poignant reminder of the immaculate man they were trying to save.
‘Look, I don’t know if it means anything,’ Vic spoke, his voice shaky, unsure of his reception, but Guy was open to any suggestion and nodded urgently for Vic to go on. ‘He said something about a sore back last night when he went home.’
‘He could have a ruptured aortic aneurysm,’ Guy said, referring to a dire surgical emergency where the main artery of the body ruptured.
‘He strained his back, moving a box with me, last night,’ Madison said, shaking her head. ‘I was there, Guy. It was a simple strain, I saw it happen myself…’
‘Open a thoracotomy tray,’ Guy called, and almost on autopilot Madison went to retrieve one. She set it up to open Gerard’s chest, to rip through his sternum so that Guy could visualise the heart, massage it with his hands, clamp the aorta, tie off a bleed or remove a clot, do something, anything, that might prolong this wonderful life. But all Madison knew was that Gerard wouldn’t have wanted it.
‘We did everything we could.’
She’d heard it said so many times, had used the sentence herself on many, many occasions, but maybe for the first time Madison knew exactly what it meant. That sometimes to do everything you actually had to be brave and do nothing—because nothing modern medicine had to offer was going to help now. Despite heroics, despite best effort, nothing could make a difference for Gerard—certainly not ripping open his chest with a saw.
‘He’s gone.’ She couldn’t believe she was saying it, yet she knew that it was true. Knew that going on even a moment longer was an indignity, that Professor Gerard Dalton had gone and nothing was going to bring him back.
‘He might have…’ For a second Guy wavered, torn between hope and truth, and for the first time Madison actually looked at him, took in the man she’d never formally met but who seemed somehow to understand the atrocity of what had taken place. Dark blond hair flopped over his forehead, the same raw anguish she had first witnessed when he had knelt down beside Gerard’s lifeless body in the entrance hall more visible now. His hazel eyes stared first at her then down at his patient, his tall, muscular body slumped in resignation, the rhythmic massage stilling. But his fingers were still knotted together over Gerard’s chest as he stared at the monitor.
‘There’s no history?’ he checked. ‘Any pre-existing—?’
‘He’s a workaholic,’ Madison whispered. ‘That’s all I know.’
And