Bernie McQuillan

The Emergency Room

Bernie McQuillan

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Three hours after his shift should have finished, Mike was still working in the Emergency Room in St Vincent's Hospital on New Year's Eve. His bleep vibrated again, calling him to Resuscitation and he walked past the waiting patients sprawled on plastic chairs along the corridor and down to the emergency entrance. The automatic doors flew open and a couple of burly ambulance crew stretchered in another bloodied mess, bright red like the tinsel still threaded across the tops of the computer screens at the nurse's station. Nurses ran between the curtained booths, shouting instructions to one another. Mike reached into the purple box of chocolates beside the computers but only the hard toffees were left.  

          'We've another three vehicles stacked up out there,' the ambulance man said, shaking his head when he saw the queue for triage. 'That mist's really caught them out tonight.'

          Geoff, one of the Emergency team, called Mike into one of the resuscitation rooms. A young girl of about eighteen or nineteen, blonde hair in a ponytail, lay inert on the trolley while a nurse attached a set of monitors to her chest. Mike looked at the girl's bruised arms, the slack mouth and thin, mottled legs below the short dress.

          'What's she taken?'

          Geoff shrugged.

          'No one came in with her. But it looks like the same batch as the lad from last night and he didn't make it.'

          He lifted the girl's eyelids to shine a light on the dull pupils.

          'Come on kid. Mike's your best hope.'

          He filled a syringe with a pink liquid, flicking the needle with his finger before injecting it straight into her left arm.

          Mike shook his head.

          'I can't do anything with her in this state,' he said. 'If there's any change, call me in.'

          Geoff nodded.

          'You look wrecked, mate. Maybe see you at the party tomorrow night? Bring Cassie?'

          Mike had forgotten to mention the party to his wife. He drove slowly out of the hospital car park and through the city centre, past the queues of shivering girls in mini-dresses standing outside nightclubs, drinking neat from bottles stashed in handbags. He thought about the girl on the trolley. There were kids like her in the Emergency Room every night but there was something about this one, maybe the fact that she'd been brought in alone, that made you think it was going to end badly. He wondered how he'd feel if he'd had a daughter like that, abandoned in her hour of need.

          Not that it even seemed likely now. Cassie hadn't wanted to have the baby when she'd got pregnant two, nearly three, years ago. She'd had a termination and he couldn't say no, he wanted the career too. After that, there was always a reason not to try, a next step to climb, until he'd stopped mentioning it. They hadn't seen each other much in the last few months, their off duty didn't match and she was working in a children's hospital miles away from their house in the country, the one he'd insisted on buying rather than the city apartment that she had wanted. All because of the grubby back field, dotted with straggling fruit bushes, that Mike called an orchard and was determined to nurture. It reminded him of his gap year, picking apples on his Uncle's farm in the Adelaide Hills, their juicy red-tinged skins staining his hands for weeks after he'd returned home. 

          He knew it was easier for Cassie to stay with her mum rather than face the crawl home, only to turn around and do it all again six hours later. Still, she was coming home tonight, she might be there already, waiting for him. They'd have a bottle of Shiraz and he'd tell her about that young girl. Maybe they could talk like they used to, think about a holiday, a baby even. Some of his crowd had shipped back to Australia for another couple of years and sent photos of themselves, barbecuing the steaks in flip-flops. Cassie hadn't wanted to go back, she wanted to finish the Consultant qualifications and 'make a difference'.

          'Take a look at that lot,' he'd said to Cassie one night, pointing to the television images of the Middle-East where children, with beautiful dark eyes clambered over boulders in flimsy slippers to escape the snipers. 'There's another whole bunch of children waiting to take the place of those you've failed. The queue never gets any smaller.'

          He was almost out of the mist now, climbing north into the hills, the lights of the city behind him and just a few miles from home. He heard the rattle from the boot as the car bounced over a pothole and he remembered the two apple trees he'd bought that morning, ready for planting, their sweet fresh perfume flooding the car. His mobile vibrated on the passenger seat and Cassie's name flashed up.

          'Love, pour us a glass of red and I'll see you in five.’

          A pause. 'I'm sorry sweetheart, I'm not at home—’

          He sighed, no longer anticipating the crackle of sticks in the grate and the spice on his tongue but a cold bed and empty fridge.

          'I just couldn't leave, they were short-staffed again—’

          'Cassie—’ 

          'I know. I know what you're going to say.'

          Final sharp corner up ahead.

          'I just wish you'd think of me, that's all.'

          Long straight bit in front. He relaxed, pressed his foot on the accelerator.

          'I'll make it up to you—’

          A figure loomed out of the darkness to his left. Cursing, he spun the wheel, pumping the brake until his calf ached. The mobile fell and the car came to a shuddering halt. Below his foot, he heard Cassie's anxious voice.

          'Mike? Can you hear me? Are you there?'

          He sat for a moment, his hands rooted to the steering wheel, staring out the windscreen as the engine idled. The sky was lit up like a Christmas tree with the city a distant glow, reminding him why he had chosen to live out here. Cassie was calling his name again and he lifted the phone from the floor and cut the line. For a moment, he thought about driving on. He could say he'd hit an animal, no one would be any the wiser.

          He sighed, climbed out and swung the phone's beam along the road, picking out a shape on the ground behind the car. As he walked closer, he saw a cracked helmet, eyes closed under a dark fringe, the slight body arched as if in recovery position. A bicycle lay nearby, no sign of a light on the twisted back wheel. He knelt down and ran his hands carefully along the girl's neck and spine, checking the blood oozing from cuts to her knees. Tiny stones glistened in the wounds. A porch light flicked into life across the road and he realised there was a house just a few feet away. He cursed inwardly, the fantasy of leaving thwarted.

          The door opened and a figure emerged and shuffled down to the gate, peering over the railings at the bundle. He raised his light, picking out the fluffy dressing gown and slippers but the voice was sharp and brittle, louder than he expected. He was more used to the timidity of old ladies silenced by hospital routine.

          'Is it a sheep that's down?'

          He gave her his hospital smile.

          'A girl has fallen off her bicycle. Do you think you could get her a blanket?'

          The woman looked at him steadily for a moment, bright eyes under the short grey crop and turned back into the house. The girl moaned and Mike cupped his hand behind her neck, carefully lifting some stray hairs away from the scratches. Shivering, her eyes flickered and opened and he looked at her until she focused on him. She was so fragile, as if she was made of bone china, like Cassie.

          'What's your name?'

          'Angie.'

          'I'm a doctor, Angie,' he said. 'I need to bring you to hospital, to get you checked over. You'll be out again, quick as anything, I promise.'

          He kept his voice light, he knew that she'd be there for hours. No wonder she was cold, wearing a jacket that wasn't windproof. She couldn't have been planning to cycle far. The front door of the house opened again and the woman emerged, carrying a rug. Mike draped it around the girl's shoulders. The woman leaned over him. He felt Angie shrink back against the rug.

          'Are you sure she doesn't need an ambulance?'

          Mike saw a flicker of alarm cross Angie's face. He glanced at his watch and saw that it was just after midnight. He thought of the city centre and the drunks and the wait in casualty, the girl with the needle pricks all down her arms.

          'No, I'll bring her in. Could you open the back door of my car?'

          The woman's eyes narrowed.

          'I'm a doctor,' he added, scooping Angie up in his arms. 'I'll take good care of her.'

          The girl groaned again and turned into the warmth of his body, her light flowery scent reminding him of Cassie's favourite. The woman moved slowly towards the car and opened the back door and released the rich sweet smell from the apple plants. Mike laid Angie carefully along the seat and removed her helmet. He covered her with the blanket and closed the door. Bending down, he lifted the mangled bicycle and threw it into the hedge.

          The woman mumbled something that he didn't quite catch. As he accelerated away, he saw that she was still standing outside. He angled the mirror and saw the girl watching him.

          'I don't want to go to hospital,' she said. 'Just drop me in town. Anywhere will do.'

          'Sometimes people faint after a fall. You don't want to be on your own, just in case.'

          Not wanting to sound like a know-it-all, he smiled at her in the mirror and noticed the gap between her top teeth. Cassie had worn a brace for two years during medical school and now her smile was perfect, although he couldn't recall when he had last seen it. As the car descended the hill, they hit the mist again and he dimmed the car lights so that he could see the edge of the road more clearly. 

          'What about your bicycle? How will you get home?'

          The lights of an oncoming vehicle snaked across the car's interior and lit up Angie's face, the pale skin, shadows under the eyes, not quite as young as he'd first thought. Or as carefree. She shrugged, looking out the window at the city lights, hazy through the mist.

          'It wasn't my bike, anyway. I'll just borrow another one.' She turned her head back towards him. 'Have you any water? My head hurts.' Her voice croaked.

          There was a bottle in his work bag but it was out of reach on the floor of the passenger seat.

          'Hang on. I'll pull over,' he said and turned into the lay-by that he was familiar with on this stretch. Lorries sometimes parked up here but it was empty tonight. He opened his seatbelt and reached across to his rucksack, removed the bottle of water and turned to offer it to Angie. She was slumped back against the car door, eyes closed, her face drained of colour, beads of sweat dotting her forehead.

          'Jesus.'

          He grasped the bottle and climbed into the back seat, leaning in against Angie's mouth to check her breathing, feeling for a pulse under her chin. Her skin was like marble, but after a few seconds, he felt her breath on his cheek. His hands shook as he opened the water and held the bottle to her lips. He knew what way it could go with head injuries, he'd seen it often enough. One minute, the patient was sitting up, keen to chat; the next, they were gone.

          'Drink,' he ordered and she nodded, eyes still closed.

          A few drops escaped and ran down her chin and her tongue snaked out. She looked so vulnerable, like the girl in Resuscitation earlier. He wondered if Geoff had been able to contact the girl's family and whether he could have done more for her. He reached out and stroked Angie's face and there was a ripple of movement as if his touch was painful. Her face had that worn look, of youth eaten away before it had fully bloomed, like the worm-infested apples in his orchard. He moved his hand away and down onto her hips and she flinched.

          Cassie was probably texting him right now, worried that something had happened to him. Why couldn't she be here for him, just once? She was meant to be his wife, his lover, for Christ's sake, but he would be sleeping on his own again tonight. Other women wanted him, there had been offers over the years and he'd always refused, knowing he had something better at home. That's what he used to think. He closed his eyes for a moment and the faces of Cassie, the girl in the hospital and Angie blurred together, their dark eyes and gap-toothed grins laughing at him.

          He pressed his nose against Angie's neck, her perfume reminding him of his camping trips on Mount Lofty with Cassie, lying in her arms listening to the frenetic chirping of the crickets. He closed his eyes and touched his lips to her cool sculpted mouth. It had been such a long time since he'd kissed his wife. He ran his hand down over Angie's thighs and lay against her on the narrow seat. His watch strap rubbed against her leg and she groaned and he saw that there was fresh blood seeping from her knee. He cupped her belly and saw how it strained against her jacket. Her eyes flew open, her hand reaching out to push him away.

          It was all Cassie's fault.

          The phone in his trouser pocket vibrated. He paused and heard the distant wail of a siren. Panting hard, the blood pulsing in his ears, he sat up. The noise became shrill and flashing blue lights circled overhead as an ambulance sped past and up the hill. He clambered back into the driver's seat and reached for his wallet, extracting a wad of notes. In the silence, Angie adjusted her clothes and opened the car door. Mike turned and thrust the cash towards her.

          'Please,' he said. 'Take it. For the bicycle.'

          She stared at him, her eyes like black drills boring into his head, then she climbed out and limped across the gravel to the road. In his mirror, he saw the beam of an approaching car. Angie kept on walking, her arm outstretched, thumb cocked. The car slowed and pulled in beside her and she leaned down to talk through the passenger window before opening the back door. She turned and looked towards Mike, one hand aloft and the other cupped around her mouth as if  she was shouting to him.

          As he opened the car window, he saw the faint green light of an incoming text blink at him from her raised palm and her voice reached him on the wind.

          'Cassie sends her love.'


Bernie McQuillan


Bernie McQuillan, from Co Tyrone and living in Belfast, has had short stories published in The Incubator, Spontaneity, Woman's Way, Birmingham (US) Arts Journal. Her flash fiction was recently long-listed for the Fish Award. She is currently completing her novel 'Maggie's Year' and working on a second 'Uncle Derek's Betrayal' and can be contacted at @BernieMcQuillan