After the End(44)

And so off we set, an unlikely procession of doctor, nurse, porter, and me. And Dylan, a king held high in his sedan, an Indian prince on his elephant. Cheryl wheels the monitor, and I take the drip stand, and Dr. Khalili walks briskly in front. We take a circuitous route through the hospital, avoiding the drop in temperature for as long as we can. I don’t take my eyes off Dylan; Cheryl doesn’t take her eyes off his monitor. His sats wobble, but don’t crash. His heart rate slows, but steadies.

And we make it.

I sit on the bench, damp seeping into my jeans, and Dr. Khalili lifts my light-as-a-feather boy and places him into my arms as though I am a new mother once more, and she the doctor who delivered him.

“Ten minutes,” she reminds me, gently but firmly, and they step away. It is still not light, but the blackness of my drive here is giving way to an opaque darkness. Behind us, the hospital buildings are dressed in sodium-yellow lights and the headlamps of arriving cars, but in front of us, an expanse of lawn stretches down towards the city.

“Not long now,” I whisper to Dylan, because the sky is already turning from grey to blue, and there’s a hint of gold on the horizon. “I want—” I break off, but it’s important he hears this. It’s important I say it. “I want you to know that I have loved you since the moment I knew you existed, since the moment there was even a chance that you existed.” I touch my fingertip to the birthmark the colour of milky tea, and I hear Max’s laugh—At least I know he’s mine—and I squeeze my eyes shut to block out the pain of the day that was so perfect.

“When you were born I promised I would keep you safe and never let anyone hurt you. And . . .” I breathe out slowly, determined to finish without crying, to show Dylan I can be brave too. “And I’m so sorry I couldn’t keep you safe from illness, but I’m going to keep you safe now, baby. I’m going to take away everything that hurts, and all those wires and tubes and all the medicine. And when the court case is over, and you’re allowed to go to sleep, it will all be over.”

I cry silently, tears streaming down my face as I swallow the sounds that might tell Dylan I am upset. And as my son lies warm in my arms, and the cold breeze kisses our faces, pink and gold colours the skyline, bringing up the rooftops in sharp relief, and my boy sees the sun rise.





eighteen





Leila


There’s a particular sort of energy in PICU when a child’s condition tips from serious to critical; from stable to a state of emergency. The emergency buzzer summons at a run whoever can hear it, yet despite the extra resources that suddenly appear on the ward it will feel as though there could never be enough to catch this life that is slipping through their fingers.

Out of nowhere, Liam is crashing; his levels plummeting and a blue tinge creeping outward from his lips. The machines by his bed are playing a duet; a harsh, continuous tone peppered with insistent beeps that grow ever more prolonged as his heart rate falls.

A registrar is prepping the ventilator and suction tubes. A job performed a thousand times, yet checked and double-checked as though it were the first. Leila clears Liam’s airway. She takes the bag valve mask Cheryl hands her and presses the seal around his mouth, as Cheryl begins slow, rhythmic squeezes, pushing oxygen into Liam’s empty lungs.

“Respiratory rate’s forty. Sats are dropping.” Leila keeps her eyes on the screen, on which Liam’s oxygen levels are shown. They’ve been hovering around 96, but now they’re free-falling, too fast to call out: 88 percent, 80, 75, 69 . . .

“We’re going to have to intubate.”

“What’s happening? Is he dying? What can you do?” With each question, Mrs. Slater’s voice rises a few notes.

“Please.” Leila gestures to the side of the room, to the door, to space away from where she is trying to work. When a patient crashes on TV you see the trolley racing through corridors, the doctors shouting Crash team, worried relatives left helplessly behind. In theater, doctors work in private. Here, everything is exposed.

“We’re not fucking going anywhere.” Connor Slater’s voice is gruff and angry, fear hiding beneath the surface.

Leila doesn’t argue. There isn’t time. No time for anything except for saving Liam’s life. The registrar is ready with the ET tube, but the numbers are going down and down and the beeps are longer, longer, the space between them closing until they’re hardly there at all and—

“He’s arresting,” Leila says, as calmly and quietly as she can. She starts chest compressions.

“Will someone tell us what the fuck is going on!” Connor Slater leaves off the question mark. He wants to stare Leila down, but he can’t take his eyes off the screen where the numbers say everything, and so he shouts at her instead. “He’s not fucking breathing. Do something! Fucking hell . . .” This last is directed to the ceiling, as he stands at the foot of Liam’s bed, his fists clenched and his eyes squeezed shut against the threat of tears.

“Defib,” Leila shouts, but it’s already being pushed into her hands. Fired up. Charging. Working. Leila looks at Cheryl and nods. They place the pads on Liam’s skinny chest, pause for a second’s check that feels a second too long, and then Leila shouts, “Clear!” and she so badly needs to save this child’s life that she’s losing perspective on who she’s doing it for. A safety check, then a single shock, before chest compressions again and again and—“Again!”