The End of Men(46)

I’m sprinting and as I cross the final field to get to him I see him sitting outside the hut on a fold-up chair. His hair is shaggy, he’s got the beginnings of a beard. Oh, my boy.

“Jamie, it’s safe,” I’m screaming hoarsely.

“Mum?” I can hear his voice. I worried I’d never hear his voice again.

I reach him and crash into him, hugging him tightly. He’s taller than me and his arms are around me and I’m sobbing.

“Mum, Mum, are you okay? Mum, is it Dad? What’s happening?”

“It’s safe,” I sob. “None of them have the virus. You can come back now. It’s safe for you.”





AMANDA


Glasgow, the Independent Republic of Scotland

Day 230

Healthy people get so wrapped up in their grief for their husbands and families and friends that they forget that millions of people across the world were already sick before the Plague, and their illnesses didn’t magically cure themselves once the Plague started. Emergencies like sepsis, meningitis, appendicitis, pneumonia and kidney infections don’t stop just because the world is in crisis. I wish I could say to all the old women in Glasgow, “Would you stop fucking falling, the lot of you, I only have two orthopedic doctors left in this entire hospital.” Alas, I can’t. Even in the midst of a crisis, I have a better bedside manner than that.

This morning, we had three elderly women who had fallen and needed hip replacements or wrist surgery. All three will probably die as more urgent surgeries take precedence. In my new Health Protection Scotland role, I have the delightful job of creating an Urgency of Care Protocol, which essentially boils down to Young People Get Treated, Old People Don’t, If You’re a Man with a Working Penis We Want to Keep You Alive.

It’s a constant balancing act between the value of life and the value of resources in a hospital with ever-dwindling supplies of, well, everything. Even gauze is being rationed. We don’t have excess of anything and we receive tiny, random deliveries of supplies at unpredictable times.

This morning provided a few blessedly clear scenarios. Two women presented with urgent kidney infections: a UTI can quickly become serious without antibiotics. They both required an inpatient stay on IV antibiotics. One was twenty-two, the other forty-one with two kids. Treatment required and provided. One man came to the hospital with appendicitis; his appendix was about to burst, so with surgery he would almost certainly be fine. Again, an easy call. I called down the general surgeons and they wheeled him straight up. It reminded me of a horrible case a few weeks ago. A sixty-eight-year-old woman came in, she was in an awful state. Her appendix had already burst. I called down Pippa, our head of general surgery, and she told us to wheel her into a side room. “There’s no point,” she said. One of the other young doctors, a surgeon, was outraged. “We can’t just let her die!” She was hysterical. But I understood what Pippa was saying. We had to be pragmatic. The supplies it takes for a messy surgery, the antibiotics, the time needed for nurses. It wasn’t worth it. Pippa said we should be stingy with the morphine, which, again, I understood but couldn’t bear to follow. There’s a reason she’s a surgeon and I’m not. Sociopaths, the lot of them.

The woman with appendicitis died twelve hours later. I gave her as much morphine as I could bear to but it was an awful death. That was a difficult day.

Now we’re fairly certain that the men who appear at A and E have either beaten the Plague or are immune. For a few months it was dire; we received strict instructions from the Health Department that the Plague was not to be treated. Those who arrived at any A and E Department in Scotland suffering from the Plague were not to be allowed in the building. They were to be sent home without ceremony. Telling a desperate mother of a dying baby or toddler, and—in one particularly awful case—of eighteen-month-old twins, that she wasn’t even allowed to enter the building made me question everything. What is the point of being doctors if we’re not even trying to help people? The response when we raised it with the Health Department was simple and strongly worded: “Valuable medicines and resources are not to be wasted on patients who have over 90 percent rate of mortality.” The chances of any men or boys in Glasgow managing to avoid exposure to the Plague is now so low that, as of two weeks ago, we treat all men. Hence the painful focus of my HPS role. Oh, how they’ve changed their tune.

As tempting as it was to tell the Scottish health authorities to go fuck themselves, I want as many people as possible to survive. And so every time I treat a patient and do a shift, I add to my document, which will shortly be circulated to all hospitals in Scotland as an A and E treatment protocol. Some things are obvious. Regardless of the sex of the patient, we only give antibiotics if absolutely necessary and at the lowest possible effective dose. Blood transfusions and fluids are restricted to life-and-death situations like extreme trauma. Others have been less obvious. I suggested a month ago that every member of hospital staff, health permitting, should be required to give blood every eight weeks on pain of social exclusion and embarrassment because why the fuck are you working in a hospital if you don’t want to help? There’s a donation room permanently set up just by the staff entrance. We post on the board by the entrance the names of people who have missed their slot. Most obvious of all, anyone who comes to the hospital but isn’t really ill is told in no uncertain terms to go home.