Chapter Six
Six.
I met Johan on an iron-cold day in January, the city around me braced under an empty sky.
Back then, young and resilient, I used to leave forty minutes early so I could walk to the hospital from London Bridge.
I remember a short, blazing sunrise as I crossed the Thames, orange ripening to pink in minutes, then thin blue.
But by the time I reached the Tower of London grayness had already sunk, plague-like, and the sky remained vacant and freezing for the rest of the day.
I knew nothing of him that morning. Aged twenty-six and nearing the end of my core training, I’d taken my second MRCS exam a few days before and my thoughts were still consumed by my performance: whether or not I’d said too little at the anatomy station, whether I’d said too much at critical care.
I would not be called for a registrar interview unless I’d passed.
Of course you’ll pass! Yanika had texted the previous night. Don’t be ridiculous. You’re worrying because you’re not a white middle-class man. I’ve been there, Carrie, and I can only say, to hell with all that old thinking. Enough!
Maybe she had a point. Compared to Maya, who looks a lot more like our half-Malaysian mother, I take after our British father.
But I’d still had unwelcome comments growing up in rural Devon, and even now I’d have older patients ask things like, So where are you from?
It happened only occasionally, but it was enough for me to feel like I was on the back foot.
The cold wind flamed my face as I marched on.
Yanika was right: enough. I’d graduated from medical school with a distinction, had already presented at a national conference, and had been awarded the Foundational Trainee of the Year before getting my first choice core training post. I would of course get a registrar number, and if I didn’t rank highly enough to choose the London Deanery there were many other excellent hospitals to choose from around the country.
There was even the possibility of a year abroad. The world was my oyster.
—
Four hours into my on-call shift, somewhere in Limehouse, an elderly Turkish woman named Deniz was hit by a motorcycle traveling beyond the speed limit, and a young man called Johan witnessed the entire thing.
He tried to look away, he later told me, when Deniz’s tiny body was thrown grotesquely high into the air before crashing down on the freezing tarmac, but he couldn’t—he was already running toward her.
I remember everything that happened.
Deniz was still conscious when the paramedics brought her in, but the primary exam was so bleak the A this woman was not interested in my opinion.
As we wheeled Deniz’s trolley down toward the lifts, a police officer came through from A&E.
“Lose the police officer” was a common pastime in Emergency Medicine, and I purposefully kept my eyes down.
But—and I would later put this down to my Johan sixth sense—I found myself turning back to look at the policeman as we passed.
Seconds later, my eyes were drawn to the man he was talking to.
And for a few more minutes Johan was still just a man in a corridor.
A tall young man, deep in conversation with the policeman.
He was wearing work trousers, the sort tradesmen wear, full of pockets and covered in paint.
A rucksack with a bike helmet clipped to the side.
His eyes, striking even from a distance, swerved away from the police officer mid-conversation and momentarily met mine.
I registered a fleeting shock, although that wasn’t so unusual in trauma. Most of us operated in a heightened state.
Johan’s eyes held mine as he talked, following me.
I turned away to call the lift and check Deniz’s monitor, but then I looked back again.
Oddly, for me, I couldn’t help myself. He was still talking, still watching me quite openly.
Somewhere inside me, a warning signal. For a moment we looked directly at each other.
Then the lift doors opened and I was off.
—
It was a bad day in the department. As we came back from scan most of the team was diverted to a code red being helicoptered in from Essex, leaving me on my own to do Deniz’s secondary exam.
I began immediately, starting with the chest drain I’d been worried about. It had slipped, I was right, and the drain wasn’t swinging with Deniz’s breath. I ran across to Resus 2 to ask for help but the code red was just arriving and there was not one person I could have peeled away.
I ran back across to Deniz, whose oxygen sats were now dangerously low. I yelled for anyone else in Emergency Medicine—anyone at all—but nobody came.
At that moment the police officer from the corridor walked into the room, as if it were no more than a ward cubicle, and with him the man in the work trousers with those eyes.
“I’m sorry to trouble, you, Nurse, but I need to ascertain—”
“I’m one of the surgical doctors,” I interrupted. Yanika had taught me to shut that kind of thing down immediately. Nothing will change if you don’t, she’d said, just like my mother would have done, and they were right. “Please leave. My patient needs urgent help.”
He bristled. Police officers don’t like being given orders. “I understand that, Doctor”—a mild note of disdain—“but the thing is, this man, who was an eyewitness at the scene, has the patient’s belongings with him, and before we can release them to her we need to confirm her identity.”
The beautiful man shook his head, apologizing silently. He made to leave, but the officer put up a hand to stop him. “Also, we need to know what sort of injuries the victim has sustained, because we believe we’ve now found and apprehended the hit-and-run driver, so…”
The monitor alarm escalated.
“Out!” I shouted, as the world around me narrowed.
Deniz’s lung had completely collapsed, putting pressure on her heart.
She was close to cardiac arrest. It was too late to open a new chest drain kit, and besides, I had nobody to help me.
So I reached for a scalpel and cut the chest drain stitch, pulled out the drain, and then put my finger in through the hole.
Closing my eyes, praying, I swept my finger around the inside of the chest cavity.
The room disappeared. Just me, the patient, and a growing tide of primal anger. Yet again, I was alone and nobody was coming to help. Lost in a crowd, the people who should be there to back me up nowhere to be seen. All of them too busy. Too fucking busy.
Blood gushed from Deniz’s chest and her rhythm began to normalize on the monitor. I yelled again for help. The A&E reg and a trauma nurse ran in, pulling on new gloves. “What’s happening?” the registrar asked, bewildered.
“The patient tensioned. I had to do a finger thoracostomy.”
“Why?”
“The drain wasn’t draining. It had slipped and kinked.”
He started work on her. “I think that was a little premature—” he began.
“She’s stable because I had to stick my finger into her chest,” I interrupted. “Your stitches weren’t tight enough.”
There was a weighted silence. I realized my fists were balled, as if I was preparing to punch the man. He was a decent enough guy, this one. Chris. I’d done one of my F2 rotations under him down in Epsom.
He looked around at me for a fleeting second, and I held eye contact. Another thing Yanika had taught me. “You did the right thing,” he said after a beat. “Good work.”
He wasn’t happy, but he was a good enough physician to climb down. Plenty weren’t.
“I’ve got it from here,” he said, turning back to Deniz. “Can you show the police officer out and get Joel and Faisel in here.”
I wheeled around. The officer, unbelievably, was still there, by the door.
“What?” There was no forethought, no consciousness. It just burst out of me. “I told you to leave. Why the hell are you still here?”
The policeman stared at me, shocked at first, then angry.
“Get out!” I shouted. I couldn’t stop myself. “Get out! Now!”
“Carrie!” Chris hissed. “Stop.”
“I’ll be reporting this behavior,” the police officer said, moving toward the door. “To your superiors.”
“And so will I, to yours,” I said. I felt dangerously good.
“Plenty of eyewitnesses, too,” the policeman noted, leaving.
That’s when Johan became more than just a good-looking man on the sidelines. He was standing just outside the door as I took off my apron and gloves.
“We had no business being here,” he told the policeman. “The doctor clearly asked you to leave, twice, and you ignored her.”
The officer shook his head, red-faced, smiling condescendingly as he walked away from all of us.
Chris called to me from Deniz’s bedside. “Carrie. What’s got into you?”
“I don’t know,” I replied honestly. My hands were shaking.
“She had every right to be angry,” Johan said. “The policeman was being an asshole. She shouted for help and nobody came, this woman seemed to be dying, and she saved her life, all on her own. I think anyone would need a moment after that.”
Chris nodded briefly, gave me another searching look, and then got back to work.
I looked straight at Johan. An artwork of a man will always be either vacant or untrustworthy, Mum had told me. Never be so stupid as to be seduced by someone like that.