Chapter Five
He came in just after midnight when the department hit that strange second wind. The one where the worst of the drunken rush blurred into the genuinely injured. Football fans still filtered into A&E in pieces. Drunk. Injured. Head injuries. Broken faces. But the flow was slowing.
A trolley wheeled in briskly, the paramedic already talking before it had stopped.
“Male, mid-thirties. Assault. Found in an alley off Westgate. GCS fifteen. Facial injuries, possible rib fractures. Says he fell.”
The man stared at the ceiling, jaw clenched, one eye already swollen shut. Blood dried at the corner of his mouth, the split lip crusted dark. His knuckles were raw too. Not broken like the football lads. Scraped. Torn. The blood on them fresher than that on his face.
He was older. Too old to be fighting like this.
And this fight wasn’t alcohol. No sickly-sweet hum to his breath.
He wore old scars like badges of honour.
No tattoos covering them up. Skin puckered from where it had been broken and badly put back together.
I glanced from his face to his hands, then back again.
“Can you tell me what happened?” I asked, keeping my voice neutral as I leaned in.
He swallowed. “Told them. I fell.”
“Where?”
“Outside a pub.”
“Which pub?”
A pause. Too long.
“Don’t know.”
I nodded, like that made sense. It rarely did. I checked his pupils, pressed gently along his ribs. He flinched hard on the left, breath hitching despite himself.
“That hurts?” I asked.
“Yeah,” he muttered. “Reckon.”
There was a shape to the injuries that didn’t sit right. The bruise on his cheekbone was well developed, hours old. The blood on his knuckles fresh and the cut above his eye not quite swollen enough to be more than an hour old. The cut to his lip was older, scabbed and dried.
The injuries spread across his torso. This wasn’t a single impact. This was controlled. Repeated. Someone taking their time. A punishment. Or a lesson. Torture. My stomach dropped, unease settling low.
“You lose consciousness at all?” I asked.
He shook his head quickly. Too quickly, closing his eyes as he muttered. “Nah.”
The paramedic caught my eye. A flicker. The smallest shrug. I thanked them and they peeled away, already being called somewhere else. The man was quiet as I cleaned him up, compliant in the way people are when they don’t want attention.
“Any medical history I should know about?” I asked.
“No.”
“Medication?”
“No.”
“Allergies?”
“No.”
I sighed inwardly and straightened. “We’ll need X-rays. Ribs, face. Possibly a CT if you start vomiting or get a headache.”
“Do I have to?” he asked, finally looking at me, before glancing away again and out into the corridor behind.
“Yes,” I said. “You do.”
He nodded, saying nothing more.
“We’ll get you down to imaging as soon as we can,” I smiled, feigning confidence, pulling the curtain open to leave and turning into them.
Two pillars of dark denim and leather stood just outside the cubicle.
They wore cuts, worn and familiar, badges creating a chaotic pattern on the front.
An arc was stitched down the left-hand side.
Red and black. Ominous. Not the same as the man earlier.
Their colours were different, their energy still but oppressive.
And just something about them felt dangerous.
They stepped away as I stepped out. They didn’t block the curtain nor crowd me, respecting my space as I moved past them.
Nothing they did was unusual. But there was just something off.
One leaned against the wall and folded his arms over a wide chest. The other stood straight, eyes tracking the corridor with bored efficiency.
“Family?” I asked as I moved back towards the cubicle.
“Friends,” one of them answered.
The man on the trolley made a sound then.
“I’m fine,” he said quickly. Too loudly. “Just need patching up.”
His jaw tightened, eyes anywhere but focussing on me. Panic.
“Alright,” I said after a breath. “We’ll take you for imaging shortly.”
The men nodded. Polite. Silent. Doing nothing that should make me feel threatened. Just presence. But as I walked away, the hairs along the back of my neck prickled.
‘If someone doesn’t want you to look too closely, there’s usually a reason.’ That’s what my dad would say. Always suspicious. Always watching.
At the nurses’ station, I hesitated with my hand hovering over the keyboard.
There were protocols. Safeguarding. Police notifications.
Processes to follow when something didn’t feel right.
But when I looked back down the corridor, the curtain was still drawn, the men still there.
And nothing, not one thing, crossed the line enough to justify it. I lowered my hand.
When I glanced up again, they were talking.
One still leaning against the column, waiting outside the cubicle like a bodyguard.
The other had turned slightly, his back to me, broad and unmoving.
And stitched across that back was a patch.
A clenched fist. Blood dripping from the knuckles. My stomach tightened.
We didn’t see many patched bikers in here. The other man earlier had been the first since I’d moved back to the North East. Two in one shift was unusual. Two with different colours? My dad would’ve called that a warning.
‘Patterns matter,’ he used to say. ‘One is chance. Two is coincidence. Three is intent.’
I shook my head, told myself it was nothing and went back to work. But the feeling stayed, low and persistent, like I’d just walked past something I should’ve stopped and didn’t know why. And in the back of my mind, a memory. I’d seen patches long ago.
*****
A&E had calmed down the moment the junior doctors had stopped striking. It was as if the universe knew and had already picked a side. But I was grateful for a reprieve, even if the beginning of April had brought with it a wave of last-minute winter flu.
Every day blurred into the same pattern.
Respiratory distress. Elderly patients wheezing through thin, scarred lungs.
Children barking coughs into hollow chests.
Strong, fit adults, suddenly panicked by how hard breathing had become.
The corridors lined with trolleys again, blankets pulled up under chins, oxygen hissing softly like the department itself was breathing for them.
The waiting room sounded like a chest infection. Wet coughs, sniffing, the rattle of phlegm that never quite shifted. I would hear that noise for days. Again and again, even when this wave of infection was over and every little cough would spark my anxiety.
By mid-afternoon, I was already behind, the waiting times in the department slogging along like a child dragging their feet.
That was when he came in. Mid-twenties. Thin.
Too restless for someone claiming to be in pain.
He smelled faintly of sweat and something chemical underneath it.
Not booze this time. His leg bounced constantly as he sat on the edge of the trolley, eyes flicking around the cubicle like he was taking stock rather than waiting to be seen.
“How can I help you?” I asked, pulling his notes onto the clipboard.
“Me back,” he said quickly. “Propa bad. Been like it for days.”
I nodded, non-committal. “An injury?”
He shrugged. “Just came on.”
His gaze drifted to the drug trolley parked by the curtain. Then to my lanyard. My hands. The computer screen behind me.
“You the one who prescribes, yeah?” he asked, too casually.
“I’m the doctor looking after you,” I said. Neutral. Flat. Not looking up from the notes I was making on the clipboard.
He smiled then, an array of yellowed and rotting teeth on show. “Good, cos last time they only gave is paracetamol. Didn’t touch it.”
“And when was that?”
He cocked his head, a flicker of anger hinting a quick temper.
“When was the last time you hurt your back? Is this happening often? It might suggest there’s something else happening here,” I deflected, reading the warning sign, the stiffening of his body.
“Can’t remember a week or two. Comes and goes.”
I examined him anyway, getting him to move and stretch. Listening to the little groans and whimpers he added for authenticity but were just half a second too late. His range of motion was better than he let on. His tenderness shifted when I pressed. No red flags and no neurological signs.
“So… what you reckon?” he said, leaning forward as I stepped back, eyes still tracking the room. “You can sort me something propa for this pain?”
I met his gaze. “We’ll manage your pain safely,” I said, not missing the slight scrunch of something around his eyes, even though his smile of rotten teeth didn’t fade. I wrote a prescription for naproxen.
*****
The automatic doors to the A&E department slid back, chill night air rushing towards me.
For a moment, I was grateful. The breeze was more than fresh.
It was sharp, stinging, but it didn’t smell of hot antiseptic.
I tipped my head backwards, closing my eyes, taking a breath.
And another breath. There was a just off-fresh smell to the night.
Damp tarmac. Ambulance fumes. Cigarettes and a fruity vape scent, all diluted by thin night air.
Only ambulances sat at the hospital entrance.
Some with their engines running, others quietly breathing in the few minutes before the next wave of chaos.
I moved through the night, out into the dark, towards the shadow of the car park on the other side of the road.
Overhead lights buzzed, distorting the calmness I’d felt when I’d first stepped out.
Now the night felt too dark, like I could taste and smell it.
I dug in my bag for my keys, already replaying the shift in my head.
The kid we’d lost, the man who’d coded twice and come back wrong.
“Doctor?”