A dying fire's ember

Softness. Warmth. A feeling of well-being as I slowly drift back towards consciousness. As I open my eyes, the first thing I see is the peaceful, sleeping face of my wife as she lies curled up against me. Early sunlight bathes the bedroom in soft, white light. A quick glance at the clock on the bedside table on her side of the bed shows that I still have some time before I have to get up.

I close my eyes again and allow myself to drift off again for a while, enjoying this moment of intense peace.

A sudden stirring awakes me from this slumber. Moving closer to me and putting her arm around me, Katherine brushes her face against mine before gently kissing my cheek, enveloping me with the silken smoothness of her hair and skin.

“Thanks for letting me sleep for a bit longer, honey.” She says, tickling my skin with her breath, before luxuriously stretching out along the full length of the bed. Admiring the spectacle, I cannot help but steal a kiss before she has a chance to respond. Giggling, she wraps her long legs around me underneath the duvet. Shortly after this I'm lying helplessly underneath her as she covers my face with kisses.

I enjoy every moment of this and what comes next.

After a quick shower and breakfast, I kiss Katherine goodbye while embracing her tightly.

“I love you.” I say.

“Sure you do, now hurry up before you're late.” She responds, teasing me with a sparkle in her beautiful eyes before kissing me back.

As I make my way to the car, I can still smell her perfume on me.

Three weeks. Three wonderful weeks since Katherine and I got married and moved into this beautiful house in a quiet neighbourhood. Every day that I wake up and every time that I come home from work it still feels like a dream, with me still just being a boy dreaming about the impossible, even as it has all become reality around me.

It's only half an hour by car to my work at the local hospital where I work as a doctor. Well, not a full doctor yet, but well on my way to becoming one. Until that time I have to gain experience by working shifts, such as today at the ER.

It's almost impossibly beautiful today. It's late spring and the weather is beautiful. Not too warm or too cold, and with a gorgeously blue sky. It seems like a fitting background to the way my life is going at this point, with practically nothing else which I could ask for.

As I near the hospital, I turn off the road and show my ID card to the guard before continuing onto the employee's parking lot of the hospital. After finding a good spot and turning off the engine, I get out and lock the car.

For a moment I just stand there, enjoying the sun and faint breeze on my skin. In a moment I'll transition from being a loving husband into a caring doctor. Taking care of everything from scrapes and bruises to the occasional emergency. So far I have been lucky enough to avoid anything major, but as is the case with any ER, one has to be prepared for anything.

Taking one last deep breath, I enter the hospital through the personnel entrance and make my way to the ER. As soon as I set foot inside the hospital, the usual smell of disinfectant, latex and related flood over me. It's a far cry from the sunlight and peace of the parking lot. Here people come to recover, to pray for their loved ones, to hope and sometimes to die. Basically everything which people in daily life do their utmost to avoid.

Walking into the ER, I first spot John, another doctor in training like myself. He’s talking with one of the surgeons, Henry, who will be first in line to handle any serious cases that may come in today, if I remember the duty roster for today correctly.

“Hello John, Henry. How are things shaping up today?”

“Nothing too serious, just expecting a lot of bruises and cuts with this beautiful weather. You know how children and adults are.” John says with his trademark grin. With his unruly, curly brown hair and boyish face, I cannot help but think of him working at a children’s hospital after he finishes his studies.

“Great to hear, let’s hope that that’s all we’ll be up against today.” I respond, looking forward to spending a quiet day just helping out people with minor cases.

As I eat my lunch later that day – outside in the sunshine with colleagues, naturally – I cannot complain about the day so far. One boy had come in with a broken wrist after a nasty skateboarding accident and some others required help with bad pollen allergies.

“You were going on holiday soon, weren’t you?” John asks me, before taking another sip from his rather extravagant milkshake. To celebrate such a beautiful day with, or so he claimed.

“Yes, Katherine and I will be going on our honeymoon for two weeks, starting on Monday.” I reply, smiling as I picture what these weeks will be like.

“Sounds like it’ll be a wonderful time. Hopefully you’ll still want to come back to the poor lot of us.” John teases.

“I’ll have to think about it, maybe we’ll just stay over there.”

Laughing, John finishes up the remainder of his milkshake as I brush some crumbs off my jeans onto the ground. It’s then that both our pagers start vibrating. Grabbing my pager, its LCD screen tells me everything I had dreaded might happen: urgent case, severe trauma.

Leaving our lunch for what it is, John and I get up and practically sprint back to the ER.

What meets us there is absolute mayhem. Nurses, doctors and ambulance personnel are milling about in a semi-chaotic fashion. One abandoned stretcher stands forlorn in the middle of all this chaos while the EMTs and the rest concentrate around three of the treatment areas where presumably the patients of whatever has happened are being stabilised.

One of the EMTs spots us and heads over to meet up.

“You two got called in as well?” He asks. Barely waiting for our confirmation, he continues: “Car crash involving a bicyclist. Two young males in the car, young girl on bicycle. First two are stable, latter suffered severe trauma, presumably from secondary trauma. Possible penetrating trauma.”

“Where’s the girl?” I ask.

As the EMT points to the area closest to the ambulance entrance I quickly glance at the other two treatment areas, but spot that things are well under control there and quickly make my way to the girl’s treatment area.

Pushing the stretcher to the side to enter the area, I see two EMTs along with a nurse, and one of the new doctors-in-training busy around where I presume the girl is lying. Through pieces of packaging, strips of gauze, as well as torn and bloody clothing that are lying around and on top of her body, as well as the people standing around her it’s hard to make out what is going on.

As I enter the area with John close on my heels the nurse spots me and waves me frantically forward.

“Status update?” I ask her.

“The EMTs told me that they literally pulled her off the remains of a metal fence. Severe internal trauma and heavy bleeding. We’re trying to keep her stable until someone can figure out what the damage is.” She tells me, clearly shaken, but keeping her composure through years of professional experience.

“Did someone call the surgeon? Can we hook up our own monitor equipment?”

“Surgeon is on his way, getting replacement blood in was our first priority. I think we have some time now, though.”

At this the nurse points at the two bags of blood suspended from the stand next to the bed.

“Did anyone contact the family? Do we know her name?”

“Not yet, she was alone when it happened. She didn’t have any identification on her, either. The police are currently running their investigation.”

One of the EMTs now comes towards us as well. Her face looks exhausted and drawn out, as if she has just gone through something incredibly draining. I notice that her clothes are splattered with blood and covered with grime.

“We did everything we could so far.” She says as she is close enough, only talking loud enough for the three of us to hear. “We pulled her off a metal fence which the car pushed her into. Penetrating trauma in entire lower body, one broken leg, likely concussion and probably a lot more smaller things we haven’t found yet.”

Taking a deep breath, she resumes: “The damage inside is severe. We had to use blood replacements on the entire way to the ER, then immediately hooked her up with proper blood once we got her in here.”

She glances back at the bed where I can now see the bruised face of a girl as she lies there, surrounded by the doctor and the other EMT as they transfer her from the temporary monitor to the ER’s monitoring equipment and clean up the worst of the mess that’s lying around.

“I really hope that your surgeon can patch her up. Poor kid never saw the car coming.”

* * * * *

I have to close my eyes against the sudden bright sunlight as I open my room’s curtains. Glancing outside, I can see that it’s already shaping up to be another beautiful day, with a blue sky and no doubt a pleasant temperature to cycle to school in just shorts and a shirt.

Looking around my room, I quickly check that I haven’t forgotten anything. My backpack has today’s homework and notes in it. My bed has been… made to my personal standards, which works for me. I’m wearing the shorts and shirt that I had picked out yesterday. Seems like I am ready.

Grabbing the backpack and putting it on, I make my way out of my room and downstairs, to eat a quick breakfast before heading off to school.

As I leave the house my younger brother is still at the breakfast table, along with my mother.

“See you later.” I say.

“Have a nice day at school.” My mother responds with a smile. Meanwhile my brother seems engrossed in whatever comic he’s reading while eating his cereal.

“Shouldn’t be too hard with this weather.” I respond, while opening the door and waving goodbye.

Stepping outside, the first thing I do after closing the door behind me is to take a deep breath. This part of spring where the sun is shining a lot, and the days are warming up and comfortable is truly my favourite part of the year. Also because the air smells so good with so many flowers beginning to bloom. It smells like life.

After fetching my bicycle from the shed, I get on it and cycle down the garden path towards the road. All that’s on my mind are simply today’s lessons at school, including one small test for history. I’m pretty sure that it’ll all go fine, after all I never really have any problems with any of the subjects at school.

* * * * *

“Hey, glad to see that you’re awake again.”

“Hello.” The girl responds, smiling weakly.

“I’m a doctor here. You know where you are?” I ask her.

“In the ER, I imagine. The crash...”

I can see the girl wince as she recalls the accident. Or whatever parts of it which she can actually remember. I don’t envy her.

“Could you tell me your name?”

“Kathy.”

“That’s a beautiful name.”

At this compliment, she blushes awkwardly and changes the subject.

“Are my parents here? Did anyone contact them?”

“I’m afraid not. Could you give us your full name, maybe a telephone number so that we can contact them?”

“Of course.”

After I call over a nurse, Kathy proceeds to give the requested information. This task does however seem to have cost her a lot of energy. Quickly checking her vital signs on the monitor, I return my attention to her.

“Thank you very much. We’ll make sure that you’ll be healthy and out of here as soon as possible. I wouldn’t want you to miss this year’s summer vacation.”

“Me neither.” She laughs.

* * * * *

Once at school I meet up with my usual group of friends, including my best friend, Deborah. Many of us have been together practically since kindergarten. Not that that is so unusual in this small city, but being such good friends is.

“The history test got moved to the first block today, by the way.” Deborah informs me, “I hope you didn’t count on being able to cram for it during lunch.”

“No worries, I could do that one in my sleep.”

“That’s what I like to hear.” Deborah responds, grinning as she pats me on the shoulder.

I gently punch her arm in return as the others join in with our laughter. None of us have any issues with studying and all make sure that none of us fall behind. It’s what friends are for, after all. Sometimes it feels as if we’re like one of those all too perfect groups of friends you see in all those TV series. Not that we mind.

“By the way, did you finish that book which I lent you, Kathy?” One of the others, a girl by the name of Marilyn asks.

“Oh… I did, yes. I plain forgot to take it with me today.” I blush as I suddenly remember the book in question still lying on my desk.

“No problem, I had kind of wanted to read it again while we’re off with the family starting next week Monday, but I guess I still have a lot of other books to catch up on as well.” Marilyn responds, clearly not too bothered by it.

“Let me quickly fetch it during lunch. It’s not that long of a trip and that way I won’t have to remember to take it with me again in a week’s time.” I offer, still feeling a bit flustered.

“Sure, want me to cycle with you?”

“Another time, I’m faster when I cycle by myself. Don’t want to miss the first class after lunch, right?”

“Yes, that would be absolutely terrible.” Marilyn responds, drily, as the others snicker.

“Thanks for the offer, though. I won’t stop you if you feel like working up a sweat. I’ll make sure to buy your favourite lunch for when you get back to school.” Marilyn adds.

* * * * *

“So what are you saying, doc?”

“The x-ray scans aren’t very encouraging. Based on what I can see, it appears that the foreign objects that impaled her body may have shredded some crucial structures. We need to get her into an MRI scanner right now.”

After what feels like only minutes later, I’m squeezing Kathy’s hand before telling her to relax and leaving the room with the MRI scanner. Joining the radiologist at his computer displays, I silently observe as slowly slices of Kathy’s body appear on the screen.

Even though I wasn’t trained to be a radiologist, even I can interpret MRI scans well enough to see the massive damage that was wrought onto this girl’s body. The surgeon’s interpretation of the blurry images made with the portable x-ray scanner seem to have been a very mild interpretation, if anything.

With each new slice, I can see a shredded, bleeding liver, blood pooling between her organs, slowly suffocating them, as the same blood slowly pushes up against her mid-riff, restricting the space for her lungs.

Even though the wounds left by the metal rods and other objects still allow much of the blood to leak away, things aren’t looking good. My heart sinks as I imagine having to inform Kathy of this, even as I find myself hoping that the surgeon can somehow fix this situation.

The surgeon’s response is simple: get her into an operating room so that he can try to repair as much of the damage he saw on the scans as possible. Retrieving Kathy from the MRI scanner and guiding her to the OR is one of the hardest moments in my life. Even though I know that the chances of her making it through this are vanishingly small, I cannot let any of this show on my face. A face that is still the hope-filled face of a young teenage girl who should have her entire future ahead of her.

Then Kathy is lifted onto the OR table and the anaesthetist starts to prepare her for the surgery. She shouldn’t notice a thing of the surgery at least. As she lies there on the table, she still refuses to let go of my hand, squeezing tightly until the drugs start taking hold and she loses consciousness.

Gently putting her suddenly slack hand onto the OR table, I take one last look at her face, framed by her half-long, darkish brown hair. Then the OR assistants and surgeon move forward and I can no longer see anything. Not that I would care much to see what comes next, to be fair.

As I leave the OR and briefly head back to the ER, I am informed that the two guys who were in the car that hit Kathy are doing fine, with only superficial injuries. They are however officially in police custody while the investigation into the accident is ongoing. Exactly why the driver lost control over the car is still unknown.

Depending on the cause, and the outcome of Kathy’s situation, they might be looking at a manslaughter charge, or worse.

Clenching my fists at this news, I find myself wishing fervently that whatever happens, Kathy at least will pull through. No punishment can bring back the dead, after all. Forcing myself to breathe more calmly, I ask that I be notified once Kathy’s surgery is over.

Making my way outside, I sit down in the same spot as where I had lunch only a few hours earlier. The world had seemed so much simpler back then. Even though I knew beforehand that I would encounter cases like Kathy’s, I nevertheless have to wonder whether I’m strong enough to deal with it.

Right now I must be strong. For Kathy’s sake. For my own sake.

* * * * *

In a sense it’s funny how one can do something so innocent so many times without giving it a second thought, only to have it suddenly change into a complete nightmare scenario. You never see it coming.

I find myself wondering whether this is what it feels like to be dying. My lower body is numb, and I can no longer feel my legs. My face is pressed into dirt, with clumps of grass and small rocks mixed into it. It hurts.

On some level I can comprehend that while on my way home, I got hit by a car. Yet I never saw the car coming. One moment I was just cycling, enjoying the weather and feeling good about fetching that book for Marilyn today instead of waiting a week before returning it.

Then the sudden noise, motion and pain. A sensation of flying, of hitting something. Then just this situation of being pinned down and being unable to move.

After what seems like an eternity, I hear excited voices coming and ebbing away. Then sirens and lots of noise. I think they are tearing whatever is lying on top of me away. Maybe even an entire car. It feels so heavy.

Then voices nearby, yelling at me. Hands grabbing me and pulling at me. I try to understand what they are saying, but it’s all garbled. None of it makes sense. I just want to go home. Get Marilyn’s book and cycle back to school. Have lunch…

* * * * *

The sudden vibration and noise from my pager startles me out of my daydreaming. Or nightmare, as the case may be. Glancing at the pager’s display, I note that it’s telling me to report to the ER. Urgently.

As I arrive at the ER, I vaguely realise that I do not consciously remember walking there. Near one of the treatment bays stands the surgeon, waiting for me.

“Hi Henry, how did it go?”

“Not here. Let’s go elsewhere.”

Following Henry down into the labyrinth of hallways and small rooms that seem to make up any hospital, we settle into an empty treatment room. Both of us remain standing.

“I tried everything I could, you have to believe me. The damage was just… too much.”

As Henry takes a deep breath, I feel shocked but also strangely comforted to see a seasoned surgeon like Henry so emotionally affected by this.

“With each artery and vein I closed, another gash opened. Near the end it was like trying to sow wet tissue paper together.” Henry sighs deeply, clenching his hands in clear frustration. “I had to give up.”

At these words I feel every sliver of hope that I still had vanish. It feels as if I got punched into the stomach.

Seeing the clear distress on my face, Henry puts a hand on my shoulder.

“At this point she is fine, but we will have to stop giving her replacement blood. It’s simply leaking away just as fast as we are putting it back into her body.”

Even as my mind races to find ways to reject this clearly ridiculous proposal, the cold, analytical part of my mind that was actually trained for this kind of situation informs me that it is in fact the only reasonable course of action.

“We cannot help her.” I say flatly.

“As much as it pains me to say it, that is the case, yes.”

“I’ll be there for her at least. So that she won’t be alone.”

Henry doesn’t say anything at this, merely nodding and giving my shoulder a little squeeze before we make our way back to the ER, where Kathy is waiting.

* * * * *

As I open my eyes, I realise that I am again back in the ER. I am guessing that the surgery must have gone well. Blinking a few times, I look around me and just see a nurse at the other side of the room.

Experimentally moving my limbs, I find that I can move them far more easily now. Seems like I may have been luckier than I thought. My left arm definitely seems to be broken, however. It’s been put into a splint and feels swollen and unresponsive. It’s probably due to painkillers that it doesn’t really hurt.

I do notice the IV going into my left arm that is still dripping more blood into my body, but I think nothing of it. I must have lost quite a bit of blood due to the accident and the surgery probably didn’t help.

Noticing movement, I see the friendly young doctor entering my section of the ER again. He seems upset, somehow, even though he’s trying to do his best to hide it.

At this realisation I feel cold fear gripping my heart.

“It’s bad, isn’t it?” I ask, trying to sound cool, but instead having my voice cracking.

The doctor tries a confident smile, but then gives up and merely nods.

“The surgeon did his best, but… the internal damage is too severe.”

“Did my parents get here yet?”

“Your mother arrived and is waiting, yes. Do you want to see her?”

Struggling against a sudden flood of tears, I nod.

“Yes… yes, I would.”

A few moments later I find myself looking at the doctor and my mother. My mother is in tears, having already been informed of my situation. She sits down next to my bed, holding on tightly to my hands.

Glancing up at the IV, I notice that it’s nearly empty. Just the last drops of life making their way down to my body. A body that will soon die, and me along with it. These are my last moments of being alive.

Suddenly I feel angry. How can they just let me die like this? My body is still working. I’m young. I shouldn’t have to think about things like this. How dare they do this to me?

Glancing over at the young doctor I feel my anger vanish. He seems genuinely upset about what is happening. The nurse who is standing next to him seems on the verge of tears as well. They really must have tried everything they could.

At this thought I feel lots of tears welling up, as thoughts of my life so far and the future I thought that I would be experiencing flash through my mind. My friends at school. The book that I’ll never be returning to Marilyn. The summer vacation that will never come for me. Even silly things like me never learning the result of that history test today. My dreams of becoming a scientist or teacher.

None of it matters any more.

* * * * *

I try my hardest to not cry as Kathy’s cool composure crumbles and she is held in her mother’s arms, both crying.

Suddenly I feel a feel a hand slip into my own. Glancing over, I see that it’s one of the nurses. She’s also crying softly. I squeeze her hand and put my arm around her. There is nothing more that we can do. Except watch.

I do not know for how long we stood there. It must have been a while, as slowly the life drained out of Kathy’s body. At first she was crying a lot, then talking with her mother, even laughing at some points. Then her voice started growing tired and her mother had to lie her back down onto the bed.

The blood pressure monitor next to her bed shows cruel reality using its cold, unfeeling numbers. Each minute Kathy’s blood pressure drops again. Then it slips into the range which the cold, clinical part of my mind informs me is the danger zone. It won’t be long any more.

Though Kathy keeps struggling to keep her eyes open, ultimately the numbers win out. Closing her eyes one last time, I can hear her sigh deeply. Then silence.

A few moments later the heart rate monitor shows the cruel flat line which everyone dreads. The nurse buries her face into my coat and I can feel her tears soaking the fabric. That’s when I realise that tears are streaming unchecked down my own cheeks as well.

“Goodbye, Kathy.” I whisper.

I’m so terribly sorry.