Angus Titchford felt cheered when he pulled open his bedroom curtains at precisely 6.10 a.m.
He sat on the edge of the bed to watch the glorious sunrise and realised with pleasure that it was going to be the perfect day. He’d been waiting in anticipation for weeks to sow the vegetable seeds in his freshly raked small allotment patch. The beetroot, carrots and leeks would provide him with tasty meals in the summer months, and he’d be able to feed Josh and Jemima with home-grown goodness when they came to visit.
It was Easter Sunday too, he suddenly remembered. Beth had popped round yesterday with the Troublesome Twins, as he fondly called his five-year-old grandchildren, and they’d bought him a Lindt chocolate rabbit as a treat.
‘You’re not allowed to eat it until tomorrow, Grandad,’ Jemima had told him firmly.
‘Because you might be sick,’ Josh added gravely.
‘Oh, I see.’ Angus frowned. ‘Well that’s a bit disappointing.’
‘That rule only applies to you two,’ Beth laughed. ‘Grandad’s a grown-up, and besides, he isn’t working his way through a dozen Easter eggs like you are.’
Angus had ruffled their hair and marvelled, as he often did, how forty-odd years could have flown past so quickly. He could remember quite clearly when Beth, a small child herself, had raced around this very garden clutching her Easter basket and searching high and low for the eggs her mother had hidden amongst the shrubs and flowers.
His heart squeezed as he thought of Sandy, his dear departed wife. Four years he’d been without her now. Since she’d been gone, he’d felt as though he was just going through the motions. But over the last eighteen months, he’d perked up a bit, started enjoying life again. Pottering around the garden, spending time with the Troublesome Twins, and then he’d taken up bowls, joined the club a couple of streets away. He’d met new people who lived locally, and his game was improving too.
‘Dad … are you feeling OK?’ Beth’s concerned voice had brought him back to the moment.
He’d blinked his moist eyes. ‘Aye, I’m champion, love. Just thinking about you running up and down the garden on one of your mum’s Easter egg hunts.’
She smiled, laid her hand on his arm. ‘We can do a hunt for these two next year, Dad, how about that? I’m sure you’ll manage to out-fox them with your chocolatey hidey-holes.’
Angus had nodded and smiled. ‘You’re on. I like that idea.’
When the sun had risen fully, he stood up from the bed, grimacing as his joints creaked and grumbled. The first ten minutes were the worst, until his body managed to somehow crank itself into order. The old rack was hardly a finely oiled machine these days, but he couldn’t complain. Apart from the usual aches and pains that came with wear and tear, he was relatively healthy, and had so far miraculously managed to avoid the diabetes, ticker trouble and breathing difficulties that many of his bowls club acquaintances had to put up with.
Downstairs, he made a cup of nice strong Yorkshire tea, put his egg on to boil and buttered his toast soldiers for dipping into the soft yolk.
Sandy’s voice rang in his ears, as it did regularly throughout the day now. ‘A few grapes and a sliced banana to go towards your five-a-day.’
‘Yes, dear. I shall do it now,’ he said mildly.
Despite often speaking to himself out loud, Angus hadn’t lost his marbles – far from it. He still had all his wits about him, otherwise how was he able to finish the Times crossword every day? He spoke to Sandy because he liked doing it, simple as that. It comforted him to continue the routines they’d shared for forty-five years.
Sadly, the habit was set to be his demise on that Easter morning.
Heading for the fridge to get the grapes, he slipped on a wet patch of floor, and the next thing he knew he was lying flat on his back with a breathtaking pain shooting through his hip and leg.
His first thought was for the egg bobbing away in the pan on the hob. What would happen if the pan boiled dry? His second thought was one of pure annoyance at himself. Only a couple of months ago he’d scathingly waved away Beth’s idea to get a panic alarm installed for emergency situations just like this one.
He had fallen once before. Sprained his wrist and got away lightly. But now … now this. It was a bad one, he could feel it.
Very slowly and painfully, he managed to shuffle a few inches at a time towards the hallway, where the phone sat tantalisingly on a small table. It took him nearly fifteen minutes to get there, by which time his forehead was spotted with sweat and he felt nauseous from the pain radiating from his left hip.
He used his right foot to kick the flimsy leg of the hall table, and the cordless phone tumbled out of its charging base.
Thirty minutes later, Angus was safely in an ambulance heading for King’s Mill Hospital in the next town. He might be getting on a bit, but he had lots to live for: his garden, his loving daughter and his beautiful grandchildren. Silently he thanked his lucky stars that he’d managed to summon help.
It was going to be OK now, he felt absolutely sure of that.
Dr Nathan Mosley groaned as his pager trilled again. He was in the last thirty minutes of yet another gruelling twelve-hour shift. You never knew what you were going to encounter when that pager went off. Could be a two-minute signing of paperwork for a routine discharge, or the start of an intense two-hour treatment and monitoring of a patient.
There was just no telling until you got there.
Nathan was twenty-nine years old and had almost completed his final year as a medical intern and junior doctor in the accident and emergency department at King’s Mill Hospital in Sutton-in-Ashfield, part of the Sherwood Forest Health Trust.
He loved the buzz and pace of the emergency wards. Every day felt like he was at the sharp end of saving lives. He could never have envisaged opting for a GP role in a sleepy village like the one he’d grown up in. No, his job here had it all: unlimited adrenaline, an unrivalled sense of daily unpredictability, and many satisfying moments over the course of every shift. His duties could range from giving someone the good news that they wouldn’t lose their badly crushed finger, to spotting a serious medical problem when the patient arrived for some unconnected ailment and referring them for what he knew would be life-saving treatment.
He’d clawed his way up from humble beginnings and a few of life’s obstacles to get here. Now, he told anyone who would listen that he loved his job. But boy, was it tiring. The A&E department gave new meaning to the word. He was dog-tired most of the time these days, even on his day off. Exhaustion was like a fusty smell that clung to his clothes no matter how often he washed them. It was always there.
During training, they’d constantly been warned of the toll the shifts took on new doctors, but Nathan could never have imagined just how tired it was possible to get and still carry on working. Not to mention making crucially important decisions that affected hundreds of people’s lives every month.
He silenced the pager and strode through the waiting area, his eyes scanning the hopeful but weary rows of patients, some of whom looked at him pleadingly, as if he might be here for them. All the usual sights were present: a hastily bandaged arm, a bloodstained rag held up to an eye, a crying child cradled in a mother’s arms, and numerous worried and desperate-looking relatives of the ill and injured. The smell of antiseptic perked him up a bit, at least, and he pushed his light-brown curls out of his eyes as he fixed his gaze on the opposite side of the room to discourage any of the patients from speaking to him, and whooshed through the swinging double doors that led to the emergency wards, his open white coat billowing behind his lanky frame like a magician’s cloak.
The A&E department was classed as one ward for the purposes of internal organisation, but in actual fact it was split into four arms of patient beds – one male and one female section, and two mixed – that ran from the central nurses’ station. Instantly alert and focused, he saw the point of interest immediately over in Section 2, where a cluster of nurses and auxiliary staff buzzed around a bed at the far end.
Someone announced his arrival, and Carrie Parsons, the A&E ward manager, rushed towards him, her face tight with concern and tension.
‘What have we got here?’ he barked, not yet breaking his stride.
‘Male, eighty-two years old, admitted this morning following a fall. Hip fracture, mild concussion. Patient stabilised and monitored ready for transfer to a ward. He’s just gone into cardiac arrest.’
He remembered Angus Titchford’s admission onto the ward earlier. The supervising clinician had reported that there was no great concern over his condition, but Nathan had looked in on him a couple of times anyway. He was a plucky old chap, self-deprecating about his own clumsiness. He’d rather reminded Nathan of his grandfather, who’d passed away when Nathan had been just twelve years old.
Nathan had seen the patient just one more time to view his X-ray. Carrie Parsons had assured him she was happy to take over the supervision of Angus’s care until his transfer to another area of the hospital had been completed.
Nathan stood next to Carrie now and watched the resuscitation team at work, applying the cardiac charges to the patient’s bare chest and then standing back to wait for the shock. A growing discomfort moved up from his solar plexus and lodged itself firmly in his chest. Something wasn’t right here, but he couldn’t put his finger on exactly what.
He glanced at Carrie, trying to gauge if she too seemed concerned. But her expression was bland as a mask, as if she was simply observing a routine daily procedure. Maybe she had become accustomed to this sort of thing happening.
Yet this was the second case in the last few months where a patient admitted to the emergency ward with a seemingly fairly minor condition had deteriorated dramatically.
Nathan recalled the six-month-old baby girl who’d been admitted with a high temperature and vomiting – a suspected nasty viral infection. Following a period of intravenous rehydration, the child had appeared to be recovering; then, completely without warning, her condition had rapidly declined. Urgent tests had shown the rapid onset of respiratory failure and she had died.
And now Angus Titchford was fighting for his life even though his initial prognosis had been perfectly routine. It was unusual and troubling. Very troubling indeed.
While the resuscitation team battled to save the elderly man, Nathan plucked the clipboard displaying his information from the bottom rail of the bed. His eyes slid expertly across the myriad of readings and particulars recorded since the patient’s admission. Finally, he found what he was looking for: the heart rate variability chart.
There had been a worrying ramping up of the heart rate, and palpitations had started, for no apparent reason, less than an hour ago. It was puzzling, because there was no trace of this anomaly when the patient had been admitted, nor was any history of the problem recorded in the notes. Mr Titchford had been treated with appropriate beta blocker medication and the symptoms had initially settled down again. Then, out of nowhere, there had been another massive spike, and now here he was in full cardiac arrest.
It was unusual, even in an eighty-two-year-old after the shock of a fall. The other case, a few months ago, had been remarkably similar in that serious symptoms had suddenly appeared as if from nowhere, resulting in an irreversible and tragic outcome.
Nathan knew how carefully the hospital trust protected its reputation. Although transparent policies and procedures were in place encouraging staff to speak up if they witnessed any wrongdoing, he’d heard unofficial stories from other hospitals of how careers could mysteriously stall if people dared to do so.
He was just six months away from achieving his lifelong dream of qualifying as a full-time A&E doctor. It had been a long, long road and his achievement would taste all the sweeter for the struggle. He’d already booked a dream trip to Santorini with his fiancée, Suzy, to celebrate both this milestone and his thirtieth birthday. She didn’t know yet but he planned to use the holiday to scout for possible wedding venues. Life was good and full of promise, but Nathan couldn’t fully enjoy it with guilt twisting in his guts, lethal as razor blades.
He had to do something.
The medical team leader stood back and raised his hand for the activity to cease. The faces around Nathan faded out. It was possible the feeling he had in his chest right now was just his imagination, but he seriously doubted it. Something was wrong. He could feel anxiety pulsing and expanding inside him.
First, do no harm. The Hippocratic oath he’d pledged echoed once again in his ears.
If he spoke up and raised the alarm, then his colleagues’ jobs could be at stake. An unpleasant inquiry might ensue, and there was no guarantee he would be proven right. There might be no wrongdoing to be found and he’d be left a leper amongst his own team.
And yet the feeling in his chest grew stronger, like a bad case of indigestion. He knew he couldn’t live with himself if he just stood by and watched another patient die. Whatever the cost to his own career might be, he had to take action.
He took a deep breath in and released the air slowly before turning on his heel and leaving the ward. He ignored Carrie Parsons calling out his name, asking him to return.
He took long, determined strides until he reached the swing doors at the end of the ward. No matter what disruption it caused to the rest of the ward staff, it was time to do the right thing.
I’m walking back from the ice cream van with our 99 cones when I see my sister is on the phone.
She’s tucked my one-year-old daughter, Florence, into one of the park’s baby swings and I wave the ice creams to get their attention. My smile quickly fades when I realise that Carrie isn’t giving Florence her full attention. She’s pushing her swing but is talking animatedly, the phone trapped awkwardly between her ear and her shoulder.
My throat turns dry and I pick up my pace. It’s the perfect set-up for an accident waiting to happen.
As I get closer, I see that Florence is squealing with pleasure. She bangs her podgy little gloved hands on the swing’s security rail in front of her, and I have to admit she looks happy enough, her springy blonde curls breaking free of her bobble hat.
Carrie sees my approach, clocks my panicked expression. She holds up a hand as if to repeat her usual refrain, ‘Alexa, everything’s fine. Stop fretting!’ and stops pushing Florence so I can take over. I watch as her expression changes to an irritated frown as she focuses on whatever it is the caller is saying. She turns away and her voice ramps up an octave.
I stand by my daughter and steady the swing so it’s barely moving as I listen to Carrie’s conversation.
‘I understand that, but does it have to be today?’ She’s objecting quite strongly, obviously irked. But then the person on the other end says something else, and she sighs, as if in defeat. ‘OK, that’s fine then. No, no, if it has to be today then it has to be today. Yes, bye.’
She looks a little troubled as she puts the phone in her pocket, but tries to cover it with an eye roll.
‘Is everything OK?’ I ask, handing her a cone.
She ignores the ice cream and stares over my shoulder at the copse of silver birches behind me.
‘Not really. That was the PA to the senior head of nursing at King’s Mill Hospital.’ She screws up her face and mimics the caller as she recites the job title. ‘There’s been some kind of incident and they need me to go back in this afternoon.’
Ice cream has started to drip down the sides of her cone, and Florence is reaching up and squealing for it.
‘Has there been a big car crash or something?’ In all the years Carrie has worked at King’s Mill Hospital, I’ve only known the senior management call the staff in at short notice once or twice at the most. It’s usually only if they’re overwhelmed by something like a multiple-vehicle pile-up or, as happened once, a terrible fire in a local nursing home. But my sister has worked the last six days straight and she badly needs her two days off. She still gets easily stressed since her marriage to Cameron ended so badly.
Silently I hand her both ice creams to hold while I attempt to wrestle a squirming Florence out of the swing.
‘It’s not an influx of patients that’s the problem,’ Carrie says, staring into the trees again. ‘A situation has kicked off inside the hospital and they need all the staff to go in for some kind of urgent briefing.’
She sighs heavily with the inconvenience of it all and hands me back my cone.
‘Typical,’ I say, just as Florence buries her face in the side of my ice cream and emerges covered in vanilla goo. ‘Not fair, really, on your day off. We were looking forward to Auntie Carrie playing with us, weren’t we, sweetie?’ I reach inside the changing bag and pull out a wipe. Florence wriggles in my arms and bats her little arms around in protest. ‘You can stay here with us for another half an hour, though, can’t you? I mean, you don’t have to go into work right away, surely?’
Carrie looks at me directly. I know she’s picking up on my anxious response, and she puts her hand on my arm in reassurance.
‘This is a really good opportunity for you to be out with Florence on your own.’ She looks around the park. ‘It’s perfectly safe here and there are plenty of people around. I’d stay if I could, but they’re insisting I go in.’
‘It’s fine,’ I say brightly, ignoring my tight chest. ‘We’ll be fine.’
Carrie studies me a moment. ‘I can give you a lift home first, if you’d feel better?’
I shake my head and steel myself. ‘You get off. The fresh air will do Florence good now she’s over her cold. We’ll stay a bit longer and then head back. See you back at home for dinner, yes?’
She nods. ‘Shouldn’t take long.’
Like Carrie says, it’s not as if we’re here at the park on our own. If I got into any kind of trouble, it wouldn’t be like before. There’d be someone around to help this time. Almost without realising it, I’ve come to rely on my sister’s company whenever I’m out of the house. I even organise Florence’s appointments and activities around Carrie’s shifts at the hospital so I know she’ll be able to come with us. Most of the time I try not to think about it.
Carrie tosses her untouched ice cream in a nearby bin and hitches her handbag further onto her shoulder. ‘See you later, then.’ She turns and walks away from us, so deep in thought she forgets to say goodbye to her beloved Florence, so I know she must have an awful lot on her mind.
Carrie has worked at the hospital for the last ten years; before that, she was at the Queen’s Medical Centre, in Nottingham. Her career has been her life, particularly after her marriage to Cameron broke down a year ago. She ran into hard times financially after discovering Cameron had left her in a lot of credit card debt as a result of his personal spending, and so came to live with us about eight months ago. It caused some tension between me and my husband, Perry, at the time, but that’s behind us now. The three of us have found a way to amicably co-exist, and as I keep telling him, it won’t be forever.
‘Hey, Carrie?’ I call after her.
She turns and starts to walk backwards so she can keep moving and look at me at the same time.
‘Smile … it can’t be that bad!’ It’s an inside joke; something she often says to me.
She raises a hand and gives me a weak smile. Florence lets out an ear-piercing squawk and waves frantically to her auntie, but Carrie has turned away and doesn’t look back at us again.
It’s like she’s screened herself off and stepped into a world of her own.
Perry’s face brightens when Florence and I arrive home.
‘You two been out on your own?’
‘We’ve been at the park,’ I say brightly, even though I feel a bit shaky being out alone with Florence. ‘Just for a little while.’
He smiles and I can tell he sees it as a big step forward.
‘Just the three of us for dinner, then?’ He looks up from chopping tomatoes. ‘I’m making a ragù sauce for the pasta and it takes ages to cook, so I started early.’
‘Sounds lovely,’ I say, slipping off Florence’s hat, scarf and coat as Perry blows raspberries at her, making her chuckle. ‘Carrie will be back later, so make enough for her too.’
His face drops. ‘I thought she’d moved out at last.’ He winks at me to show he’s just teasing, but I know full well there’s an element of truth behind it and I can’t really blame him. Most men would’ve baulked at their sister-in-law moving into their family’s small three-bed semi even if it was only temporary.
But Carrie was in a desperate situation and was about to be evicted, so Perry did the right thing. I’m proud to say that’s the kind of man my husband is. On top of that, he’s hard-working – toiling on an oil rig in the North Sea two to three weeks at a time – and he’s also a great daddy to Florence. We just need to recapture a bit of closeness, make the effort in our busy lives to get some time together.
‘Carrie’s been called back in to work,’ I say, pushing a glass under the fridge water dispenser. ‘Some kind of crisis meeting at the hospital, apparently.’
Perry pulls down the corners of his mouth. ‘Sounds messy. Fancy a glass of red?’
I glance at the clock and take a sip of ice-cool water, willing myself to relax now we’re home. ‘It’s a bit early, isn’t it? Drinking at five in the afternoon. I haven’t fed Florence yet.’
‘She doesn’t need you to, Alexa.’ He raises an eyebrow. ‘We’ve talked about this. She’s a year old now; she can sit at the table with us and feed herself. Will she have some pasta and ragù?’
I shake my head. ‘I made a fresh batch of sweet potato and courgette mash yesterday. It’s in the freezer.’
He’s not giving up. ‘I can chop the pasta up finely for her?’
I put my water down and trace a line through the condensation on the side of the glass.
‘She can’t chew our food properly yet,’ I say. ‘That’s how babies end up choking.’
‘It’s also how they learn,’ Perry says lightly, winking at Florence. ‘Isn’t it, princess?’
She rocks back and forth in delight and squeals her agreement.
We’ve been through all this before and I don’t want it all again now. Perry’s away working so much, I wish he’d just leave Florence’s food entirely to me. I know what’s best for her and I actually have a weaning spreadsheet all planned out.
‘Well, have a glass of wine at least, eh? I reckon it will do you good to live a little dangerously.’ He grins and puts down the chopping knife, wiping his hands on a tea towel before planting a kiss on my cheek, not seeming to realise how tense the conversation has made me.
He travels across the room making strange ape-like moves that soon have Florence squealing again, this time in mock terror because she knows she’ll be in for a tummy tickle when Daddy reaches her bouncy chair.
I watch the two of them larking around together and smile. I can’t deny it is lovely, just the three of us at home again. But I love my sister, and she has been a real rock for me in the past. She supported me through my own nightmare, which is thankfully behind us now. Staying on with Florence at the park today on our own was a bit of a milestone and proves just how far I’ve come, even if it gave me palpitations.
Usually when Carrie and I are chatting in the kitchen before dinner, Perry tends to stay well out of the way. He’ll watch television or read one of his fitness magazines in the living room. He’s never explicitly told me he’s sick of having her around, but I can tell he’s been getting a bit restless, probably wondering if and when she’s going to get her own place again.
I do want to raise the subject of moving out with Carrie, but I’ve cried off until now because I just don’t know where to start. The last thing I want to do is make her feel she isn’t wanted, particularly after she found out just a few months ago that Cameron, the rat, is getting married again, to someone Carrie actually went to school with. She knew he’d been cheating but the identity of the woman has seemed to add insult to injury.
I walk over to the counter and pick up a small piece of chopped tomato. Seeds and red flesh ooze over my fingers as I pop it into my mouth.
I will talk to Carrie about her plans for the future.
It’s just a matter of waiting for the right moment.
With the sauce now done and the pan of boiling water waiting for the pasta, Perry starts pacing up and down the kitchen, looking at the wall clock every few seconds.
‘I thought you. . .
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