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‘Take the packs and run for it,’ Dave shouted. ‘I’ll get there soon as.’
It was still raining heavily as they panted down the slick pavement. I must be losing fitness, Jess thought to herself; she’d run much further with a heavy Army Bergen on her back with no problem at all in the past. They pushed their way through a crowd of gawpers with umbrellas to a scene of carnage: a car had obviously driven onto the narrow pavement at some speed and hit two people, both of them now on the ground. The driver was still in his seat, a very old man, his face ashen, and a baby buggy lay on its side near the front wheels. She looked around frantically to see where the child could be before spying it in the arms of a policewoman, apparently unhurt.
Over to her right, a policeman was doing CPR on a girl whose face already had that grey, hollowed-out look of a dying person. As she approached he shook his head grimly and gestured with a nod in the other direction, towards a shattered shop window behind the car. ‘There’s a guy over there who needs your help.’
‘I’ll get that one if you take over here,’ she told Emma.
Lying amid the shards of glass was a young man, moaning slightly, his legs in a pool of shocking red that was being washed across the pavement by the rain. Her stomach turned over as she approached, smelling that terrifying metallic stench of blood and fear. At first she thought the man’s leg was twisted beneath him but her stomach lurched again, even more violently, when she saw that the lower leg was completely missing.
Stop thinking. Get on with it, no time to waste. The checklist ran over and over in her head, like a mantra: C.A.B.C, C.A.B.C. Catastrophic haemorrhage, airway, breathing, circulation.
Barely noticing the blood and glass, she kneeled down, tore open her medipack and grabbed a tourniquet. ‘My name’s Jess and I’m a paramedic,’ she said. ‘This is going to hurt a bit. Just hang in there, we’re going to get you to hospital as soon as we can.’ She secured the band swiftly and efficiently just above the knee and observed with satisfaction as the pumping gush of brilliant red arterial blood slowed to a dribble.
Lifting her head for a moment, desperate for Dave to arrive, she caught sight of the ankle and foot a couple of metres away near a litter bin. It looked just like part of a discarded shop dummy, still wearing a sock and trainer, the canvas type in show-off scarlet, just like Nate sometimes wore. She thrust a dressing towards a middle-aged woman standing nearby. ‘This is really important,’ she said, urgently. ‘Get that limb, wrap it up and get it somewhere cold. Find a shop with a drinks cooler or ice cream freezer, soon as you can.’
The injured man’s eyes were a maelstrom of panic and fear. Even through the pallor she could see his well-made features: a handsome young man, perhaps in his twenties, with all his life before him. Like James. Like Scott. Come to think of it, he had a look of Scotty, with that mouse-blond hair and freckles all over his nose. He was breathing, fast and shallow: his airway was clear. She quickly took his pulse. It was faint, but at least it was there.
Airway okay, breathing okay-ish, circulation okay-ish. Where the hell is Dave?
It was only when she went to cover the end of the severed leg that she faltered. The shattered ends of the tibia and fibula bones glowed shocking pearly pink-white against a bloody mess of skin and flesh, like a leg of meat hacked by a crazed butcher.
It wasn’t as though she’d never seen this kind of injury before – in fact she’d seen it too many times in the heat and sand of the desert. She grabbed a pack of dressings, but when she went to lift the stump the man whimpered again and then uttered another long, loud, terrifying howl. Her head began to spin. That sound, that gut-wrenching primeval animal sound of a man in agony, the sound that Scotty was making as she worked so desperately to save him that day.
Get a grip, Jess. Don’t think. Get the leg wrapped and get up a morphine drip. Put the guy out of his agony.
But however much she tried to push it away, Scott’s face swam in front of her eyes. The young man’s groans were Scotty’s groans.
It was her first ever foot patrol in the desert, her heart pummelling inside her chest with terror and the effort of carrying the medical back-pack, at twenty-five kilos the weight of an average eight year old, as well as her own heavy body armour. Her head felt as though it was boiling inside her helmet as the group cautiously circled the edge of the village in the ferocious heat. No-one spoke a word as the searcher moved ahead, sweeping the dust with his long-handled detector to check for improvised explosive devices while the man behind him marked the borders of the cleared area with spray paint. Everyone else scanned the landscape for markers, piles of stones, wire or a piece of broken glass which might have been left as a secret signal to mark the position of a bomb or anything designed to divert their path towards a mined area.
They could tell the Taliban were close by, watching and waiting, because the place was deserted. The villagers were hiding in their homes and even the dogs had taken cover. The enemy would never show themselves, and knew quite well that the allied troops couldn’t fire a single shot unless they were fired at first. The tension was almost unbearable.
And then: an ear-splitting crack. Jess twisted round to see a geyser of earth erupting to the side of the patrol, just where they had passed. Someone must have stepped unwarily just a few centimetres outside the cleared zone – that was all it took. The screams of pain started instantly and, as she turned back, trying to run but encumbered by her heavy pack and body armour, the screech of yelled orders in her earpiece was almost deafening. ‘Medic! Medic! Men down, three men down.’ It was just like those training exercises, except this was for real. Everything seemed to be moving in slow motion.
She heard Vorny puffing beside her and, as the clouds of soil and dust settled, the scene ahead appeared in almost surreal clarity. Captain Jones was lying beside the blast crater cursing loudly, clutching his right hand and covered in dirt. At least if he’s swearing he’s alive, she thought. Another man was seated, holding his face in his hands. Vorny paused to see if he was okay, and Jess lumbered on towards the Captain.
‘I’m fine, just get over there,’ he shouted, gesturing impatiently into the crater. ‘It’s Scott.’
The figure was almost completely obscured by the dust and rocks that had settled on it after the blast, but just then the soldier lifted his head and emitted a long and terrifying howl which seemed to echo off the mud walls of the compound behind her, reverberating through her very being.
She fell, rather than ran, down the sloping side of the crater and, when she picked herself up, the true horror of the boy’s injuries became apparent. The blood-curdling screams and streams of profanity meant he was certainly still alive, but both his lower legs were missing, vaporised by the blast. The village dogs would come scavenging later, she knew.
The earth around his lower body was already stained red with the blood gushing from the mess of mangled flesh and bone where his legs used to be. There were only moments to save his life. She ripped two tourniquets from her own upper arm, stored there for instant access and, with hands trembling so much she could scarcely grip the webbing, managed to secure one on each leg, above the knees. She glanced towards his face, pale as the sand dusting it. Even through his goggles she could see the panic in his eyes, darting from side to side, trying to focus. ‘Hang in there, Scotty,’ she said. ‘We’ll get you sorted.’
‘Jess. Thank Christ, it’s you,’ he whimpered, through gritted teeth. ‘Just save me feckin’ life, will ya? Get me home for Chrissake. Please.’
‘Don’t you worry, you’re going to make it,’ she said, trying to convince herself as much as him.
Vorny slithered down the slope to join her and they worked together, wrapping the shattered stumps with white dressings, all the while talking to the lad, trying to calm him.
‘Nearly there. MERT’s on its way. We’re going to get you out of here. Hang in there. You’re going to make it.’
Vorny set up a drip into one arm and held the bag high, squeezing it to push the life-saving liquid into Scott’s system, while Jess pulled out a morphine autojet and punched a hefty dose directly into the muscle of the upper arm on the other side. ‘That’s it, Scotty. When you wake up you’ll be in Bastion,’ she said, as the howls tailed off into moans.
By now Captain Jones was on his feet but very pale and holding his hand gingerly, with the other lad, McVeigh, who was shocked and deafened, but otherwise unharmed. They’d identified a landing site just beyond the brown poppy field at the edge of the village. The helicopter was circling, just about to land, and she was heading across the field behind the stretcher team, carrying Scotty’s pack, when the shooting started. There was no cover, and it seemed to be coming from both sides.
She dropped to the ground, cursing the fact that any delay could cost Scotty’s life after all the work they’d done to save him. But as the helicopter turned away without landing, and the firing continued without any apparent response from their own side, she realised it was not only Scott’s life in danger. Bullets could slice through the brittle brown stems of the crop at any moment. The adrenaline rush that had kept her going throughout the time they’d been working on Scotty was dissipating, and she began to panic. It was then that she saw the red poppy.
‘Christ, Jess, what the fuck are you playing at?’
Dave’s shout, close to her ear, brought her instantly back to the High Street in the pouring rain, a scene painted in grey and red, the smell of blood, the young man’s groans, his shattered limb in her arms. She had absolutely no idea how long she’d been kneeling there.
‘Let me take over,’ Dave barked, taking hold of the leg and shoving her aside brusquely. ‘Just give the poor sod some morphine. Get a drip going and pump in some fluids, for Christ’s sake.’
Dragging herself back to the present, she stood and picked up her pack. Through the shattered glass of the shop window she could see an array of meat, liver, sausages, lamb chops, trussed chickens, all glistening with broken glass. The centrepiece was a large whole leg of lamb, the severed end pointing towards her, a neatly trimmed version of this young man’s leg. Like Scotty’s legs after that blast.
She forced her eyes away, searching the pack for a morphine syringe.
‘I’m just going to give you something for the pain,’ she said, squatting down by his head. But when she looked into his face she could see that he had gone, his eyes rolled back, his skin a deadly grey.
She shook his shoulder. ‘Stay with us,’ she shouted, shaking him harder. She pressed her finger to his neck.
‘No pulse, Dave. Christ, he’s got no pulse.’ She ripped open his jacket and shirt, and pressed the pads onto his chest. ‘Flatline.’
‘I’ll secure his airway,’ Dave shouted. ‘Start CPR, now.’
No, no, no, no, she muttered to herself, in rhythm with the pumps on his chest, like a mantra. Not again, not again. It can’t be, can’t be. Now, the rest of the world disappeared and the only thing that mattered was counting out loud the chest compression pumps: one – two – three – four – five – six – seven – eight – nine. Eighty to a hundred pumps a minute for two minutes, a quick check of the pulse and then start again. Dave was squeezing air into his lungs from the bag now, twelve breaths a minute. If we keep doing this he will come back, she said to herself, I’ve seen it happen, just so long as we can keep it up.
Just as the muscles in her arms felt as though they would crumple with exhaustion Emma returned and took over for a while, and they alternated for what seemed like hours, all through loading him onto the ambulance and the crazy race back to the hospital; even as they were wheeling him into A&E.
The doctors declared both casualties dead on arrival. They were the young parents of the baby. The old man who’d lost control of his car and driven onto the pavement at forty miles an hour was completely unharmed.
When they got back to the ambulance station Dave said, ‘Want a coffee?’
She nodded numbly and followed him into the kitchen, barely aware of her surroundings, finding it strange that she could even breathe or put one foot in front of another when she felt so completely shell-shocked. He placed a mug of hot sweet tea onto the table in front of her but when she went to pick it up her hands shook so badly that she slopped it all over her uniform.
He put a gentle hand on her shoulder. ‘It happens to all of us, you know,’ he said, kindly.
She shook her head vehemently. ‘No, it doesn’t happen to all of us, not like that. You saw me, Dave. I lost it again. Some kind of flashback thing. God knows how long it was before you arrived and took over.’
‘Only a few moments, I’m sure. Besides, you’d already controlled his bleeding.’
‘But the delay could have meant the difference …’ The thought was simply too enormous and too terrible to contemplate. She felt overwhelmed and exhausted; barely able to think straight.
After a long pause Dave said: ‘I think you need to take a few days off. Why don’t you ask Frank?’
‘Oh God, I couldn’t face Frank, right now.’
‘Do you want me to ask him for you?’
She nodded.
‘Okay. I think you need to talk to someone, but perhaps not today. The best thing for you now is to go straight home, have something to eat and a couple of glasses of wine. Try to think about something else. I’ll text to let you know what Frank says.’
It was this simple act of kindness and understanding which finally broke the dam, opening the door to all the horror, the guilt and the shame. She began to weep, with long, agonising gasps that seemed to wrench all the air out of her lungs. Dave moved his arm around her and she rested her head on his warm, broad shoulder till the sobs abated.
Chapter Four (#u1b060469-86bc-5910-b283-ab87400613d0)
She was relieved to see her father in the station car park because he wouldn’t ask too many questions; after a heavy date with a whisky bottle, she was feeling particularly fragile.
When she’d got back to the flat the previous day she’d found it deserted and remembered that Vorny and Hatts were away on exercise for two weeks. She slumped down on the sofa and wept, desolate and desperate for someone to talk to. Why weren’t they here, when she’d needed them most? She considered calling Nate but decided she couldn’t dump her problems on him, not just yet. After a while she dried her eyes and stomped around the flat wondering what to do with herself. Then, reluctantly, she dialled her parents’ number.
‘I’ve got a few days unexpected leave, Mum. Can I come and stay?’
‘Of course, dear. Are you all right?’
‘Ish. Talk tomorrow, okay? I’ll be there on the five o’clock train. Can someone pick me up?’
As they drew up to the house her mother was on the doorstep, with Milly the dog, both regarding her with inquiring eyes. Why the unexpected leave? Why wasn’t she spending it with Nathan? Of course her mother was far too wise to ask directly. Jess would share any problems, in her own time. She always did.
‘How’s things?’
‘Fine, thanks. Glad to be here.’
‘You look pale, love. Are you feeling okay?’
‘Just a bit weary. Heavy week.’
The truth was that she didn’t really feel anything much right now, except numb and confused. All her adult life had been spent working towards, training and then becoming a medic. She’d wanted to make a difference, to save lives and she’d loved it, mostly. Until yesterday she had been determined to spend the rest of her life doing it, couldn’t imagine any other form of career.
But somehow all that certainty had now disappeared, washed away like the poor young man’s blood on that dismal pavement. She had broken her promise to James, her vow to prevent anyone dying through any delay in stemming their loss of blood.
The future felt like a quicksand, untrustworthy and perilous. Last night, during her long commune with the bottle, she’d argued with herself, sometimes out loud, as the logical, calm voice of reason struggled to be heard over what her instincts seemed to be shouting:
You’re a good medic, well-trained, highly experienced. You’ve made a difference, even saved lives.
I’ve failed to save lives. I failed that young man. I punched that idiot in the street.
Just a couple of blips, you’ll get over it.
It’s not that. I can’t trust myself any more: the flashbacks, the anger. I failed my promise to James.
Just two events in four months, Jess.
I’m a danger to patients. My confidence is gone. The thought of going back to work makes me feel panicky and sick.
You could get help, counselling perhaps? That’ll sort it.
Do I want to put myself through all that self-examination crap? Anyway, I don’t know if I really want to go on putting myself on the line every day.
Okay, so give up being a medic. But you need to earn a living somehow. What would you do instead?
Oh Christ, that’s it. What else could I do? There is nothing else.
The argument raged in her head until, finally, she’d passed out, fully dressed, on the sofa.
Jess had envisaged walking with her mother on the beach, perhaps sitting on the dunes, a neutral, impersonal place to talk because you naturally sat looking outwards, your eyes drawn to the sea and the horizon, rather than facing your companion. Quite why this made it so much easier to be honest with yourself she never completely understood, but it always seemed to work.
She recalled days and nights of teenage angst when she would rush to the sea, weeping her eyes out over some spotty, undeserving youth, or spending hours with her best friend in the dunes dissecting every nuance of their latest romances, imagined or real. Alone or in company, self-pity never survived for long out on the beach. The soothing, rhythmical shush of the waves, the wide open skies and grey sea stretching to infinity always helped her to find a sense of proportion, reminding her of how small and insignificant we are in this vast universe, how unimportant our problems in the wider scheme of things.
But this time it didn’t turn out like that.
After breakfast, she’d just made another pot of coffee and was sitting at the kitchen table while her mother fussed around, washing up, putting away. Her father had drifted off to his greenhouse.
‘Look what I got for supper,’ Susan said, pulling something out of the fridge. ‘I went to that lovely butcher’s yesterday. I know it’s your favourite.’ She placed the parcel on the table and unwrapped it, revealing a large leg of lamb, its severed flesh oozing dark red blood onto the worktop.
Jess had time to blurt out, ‘Lovely …’ before the nausea hit her, like an unstoppable wave. She made it to the cloakroom just before she vomited, violently and uncontrollably, into the toilet, groaning with pain as her guts turned themselves inside out. She gagged, again and again, her throat burning with the vicious acid residue of last night’s whisky.
She heard her mother at the door and then by her side, and a soothing hand stroking her shuddering back. When it was all over she allowed herself to be led back to the living room, on trembling legs, gratefully accepting the glass of cool, clear water she was offered.
Her mother sat down on the chair opposite. ‘Are you feeling better now?’
Jess nodded.
‘What was it? Something you ate, do you think?’
Jess took a sip of water, trying to delay answering until she’d put her jumbled emotions into some expressible order. She was about to brush it off with a jokey remark about a dodgy take-away but then, as if the phrase had formed itself independently of any conscious thought, the words came out of her mouth: ‘I’m giving it up, Mum.’
‘Giving what up, love?’
‘Being a paramedic. I’m going to quit. I can’t do it any more.’ Just as soon as she heard herself admit it, an almost overwhelming wave of relief sluiced through her body.
Her mother’s eyes widened, but she managed to keep her voice calm. ‘This is sudden, Jess. I thought you loved the job? Has something bad happened?’
The tears began to flow freely as she found herself describing the events of yesterday. The way she’d lost control, found her mind flashing back to the desert, the shocking outcome.
The discussion that followed went much along the same lines as the internal debate she’d had on the sofa with the whisky bottle last night. Her mother made all the reasonable responses: take your time, seek some help, you’re a great medic, it would be a loss to the service, it’s what you’ve been working for all your life. But the more the conversation continued, the more Jess became convinced that what her inner voice had been telling her head was right. She couldn’t carry the responsibility of saving people’s lives, not any longer.
Eventually her mother stopped offering suggestions. ‘It’s your life, my love. Whatever you decide will be for the best.’ She leaned over and stroked Jess’s hand. ‘But shouldn’t you also get yourself checked over by a doctor to find out what caused you to be so violently sick?’
Jess hesitated, unwilling to inflict another disappointment, but she would have to admit it in the end. ‘I’m sorry, Mum, but it was the leg of lamb. It brought everything back. It’s what that terrible stump yesterday reminded me of, and when I stood up afterwards there was a butcher’s just beside us and the meat was just like that poor young man’s flesh.’ She shuddered involuntarily, remembering the red of the meat and the silvery slivers of shattered glass.
They had fish and chips for supper instead and, much later that evening, after her father had gone to bed, they sat on the patio together watching the stars come out. It was September now, the evenings were drawing in and there was a dampness in the air with that autumnal countryside smell. She always found this time of year melancholy: the swallows gathering for their long migrations, the changing sounds of birdsong, dew on the grass in the morning, the yellowing of the leaves. They all felt like endings. Only this year she was facing a very personal ending, a big, terrifyingly full stop to what had been driving her, her reason for living, her passion for the past ten years.
After a while it grew cold and they went inside. ‘Whatever am I going to do with myself now, Mum?’ Jess said, cuddling up on the sofa with Milly, who wasn’t usually allowed to sit there.
‘Have you got any ideas?’
‘Not a clue,’ she admitted.
