Jubilee (21 page)

‘How are you doing?’

‘Fine.’

Satish washes his hands. The clock ticks. 3.10 a.m. He reaches for the defibrillator.

‘He’s out?’ he asks.

‘Out.’ Clare steps away from the bed, turns her full attention to the monitor. Charles is bagging the child now, pushing oxygen into his lungs. They’re ready.

‘Charge.’

As the defibrillator charges, Satish watches the child’s chest, its speedy rise and fall. In that brief moment he thinks of Mike Halloran, the fly-boy, and of all those cardiac surgeons with their God-complexes. Maybe they need it, those golden boys, because it’s not like that for him. This is a moment of calm. He’s going to do his job. He leans forward.

They all jump when the knock comes on the door.

‘No!’ shouts Satish, low and clear. He extends the paddles towards the baby. Outside there’s a scuffling sound, voices. The door bursts open; he sees Kawther looking stricken, but he’s focused on the woman in front of her. It’s Sarah, and as she lunges into the room, he realises: this is Louis.

‘Wait!’ she tells him. ‘Hang on! What are you doing to him?’ She comes so close he has to swivel to prevent her from touching the paddles.

‘He’s very sick, Sarah. I need to shock his heart, try to get it back into a normal rhythm.’ Satish reaches over, replaces the paddles, dumps the charge. He can see the baby – her baby, he corrects himself. Sarah sees him, too, intubated, bagged, unmoving under the weight of the anaesthetic. Her expression falters.

‘I know he’s sick. I want to know what
you’re
doing to him.’

Charles and Clare have heard her emphasis. They twitch towards Satish, like watchful meerkats.

‘I’m the duty consultant tonight, Sarah, and I need to act quickly. Please step outside with Kawther. She’ll explain.’

‘You’re pressuring me.’

‘He needs help right now.’

‘You’re – ’Then she puts herself between Satish and the bed, her hands held up defensively. She’s wearing the scarecrow outfit of a mother pulled from sleep by a medical emergency: the baggy sweatshirt, pyjama trousers, shoes without socks. ‘This is happening too fast. You’re pressuring me. I know he needs treatment; I just don’t think
you
should do it.’

Kawther breaks the pause that follows. ‘Mrs Stevens, it’s the middle of the night. Dr Patel’s the duty doctor, and Louis needs help right now.’

Sarah’s still holding a hand out to keep Satish away from Louis, her other hand pulling at the hem of her sweatshirt. When she speaks next, he’s taken aback by the force of her words.

‘I know he needs help. I’m not stupid. I just don’t want
you
to give it. I want another doctor. You won’t – he won’t …’ She turns to Kawther. ‘I have good reason to believe that Satish – Dr Patel – won’t do the best for my son. He’s emotionally involved. He’s not the right person for this. Call someone else.’

Kawther’s a professional, but this is solid gold, Satish can tell. He can imagine how this will play out in the staff canteen:
emotionally involved
, she’ll tell them.
Satish!
Charles shifts at the head of the bed. Clare looks up from the monitor. Satish wants to throw them all out, to get rid of the witnesses. Instead, in the quiet following Sarah’s statement, he knows that something is required of him.

‘Sarah and I knew each other as children,’ he tells them. ‘That’s what she’s referring to, I think. We didn’t get on well back then, and until last week I hadn’t seen her for over twenty years. Sarah, you’re understandably anxious about Louis, and I think that’s making you feel … unreasonable things. I am not emotionally involved with you or with him.’ Every word a clue, every word a window to see into.

‘His blood pressure’s dropped,’ says Clare. ‘Systolic of 70.’

‘Listen, Sarah.’ Kawther’s voice has taken on an edge. ‘Louis is in a critical condition. Dr Patel is straight down the line, I promise you. Nothing would interfere with his treatment of your son.’

‘I demand someone else!’

‘There is no one else. No one. And there’s no time.’

Sarah sets her jaw. ‘I don’t trust you,’ she tells him, her voice unsteady. ‘This is unethical.’

‘Satish …’

‘Clare?’

‘Systolic’s down to 60.’

‘Charles?’

Charles is bent over Louis. ‘He’s getting harder to oxygenate.’

‘I’ve got a bloody good lawyer!’ Sarah’s saying. Both her hands are fisted, her arms rigid at her sides. ‘He’ll go over everything you do here, every decision. He’ll
have
you. If anything happens to my boy, he’ll have you.’

‘Sarah, I’m going to ask you to leave.’ Satish reaches over to charge the defibrillator. ‘And I’m going to tell you why. Louis’s BPs have dropped to a dangerous level. He’s about to arrest.’

‘Oh God, oh God …’

‘I’m in a room with two other people, and I couldn’t get anything past them, even if I wanted to.’ He feels the bottle in his pocket, bumping against his hip. ‘You need to trust me. You need to leave.’

‘Do you want an apology? For something that happened thirty years ago? For a mistake made by a kid? Frankly, if that’s what it takes, I’ll do it: I’m sorry. Take care of my boy. Don’t hurt him.’

Her raised voice has brought a nurse: Satish can see her barrelling down the corridor towards them. Then Kawther pulls Sarah from the room. As she disappears from view she looks towards the bed, to Louis, small and exposed, then across at Satish.

‘Tell me I can trust you,’ she says.

Satish meets her gaze, the paddles raised and ready.

‘Of course,’ he replies, and then the door shuts.

Most paediatricians will tell you that their job changes once they have their own children. For Satish, the change happened like this: once Asha was born, he realised he was treating two sets of patients every time he did a consultation. The child had always been there, the kid with a hole in the heart, or narrowed arteries, or the more complex issues: transpositions, tetralogy of Fallot, cardiomyopathy. There were always kids with symptoms to treat, and he’d prided himself on his effectiveness as a practitioner. He’d mitigate the breathlessness, the recurrent chest infections, all the things his patients had to live with. He’d time their interventions just so, seizing the optimum moment.

With his own fatherhood, however, came the shock of discovering what the parents had to endure; not theoretically, every decent medical school taught you that, but viscerally. Asha was a few weeks old, with a fever and a rash which Satish, during the sleepless night of his daughter’s first illness, had become convinced was meningitis. He’d argued with Maya, fiercely and uncharacteristically, that they should rush the baby to the nearest A & E, until Satish’s own mother had woken, and come in, and imposed her good sense on them. The next morning it had felt like a kind of insanity. He’d let himself wonder: what if Asha had really been ill? What if they’d had some other doctor give them bad news about their child, the kind of bad news you cannot negotiate with? All the things you’d fear if they happened to you – breathlessness, chest infections, open heart surgery – they would be nothing compared with watching it happen to your kid.

In the months following this unsettling discovery, Satish’s professionalism was able to reassert itself. His detachment returned as it does to all good doctors, but his perspective changed in the process; all his cases were multiple now, the patient and the patient’s parents, their happiness up for ransom.

So, as the door closes behind Sarah, he knows exactly why she is trying to stop him treating her son, why she rails at him and threatens him and abases herself. She wronged him once, and now her entire happiness, her ability to laugh, to make love with her husband, to sleep, to think of the future with any kind of pleasure, lies with him.

The clock shows 3.18. With Sarah gone, the room is quiet again. Karma, he thinks. Karma is not retribution. It’s the natural outcome of the choices we make. How strange that their lives should have come round to this: this meeting in a hospital in the dead hours of the morning, her son struggling on the bed in front of him. Exactly how wicked would you have to be, at eleven, to bring this upon yourself at forty-one? She was not wicked enough for that; nobody deserved that.

The paddles are ready, their red lights glowing. ‘Clear!’ He leans forward and places them on Louis’s chest, spanning the heart. There’s a
click
as they discharge their ten joules, and Satish turns to the monitor: nothing. The heart’s still in SVT.

But maybe Sarah has a second chance coming to her. He charges the machine again: ‘Clear!’ Again, the click. Only this time, he sees immediately: he’s done it. The heart’s in sinus rhythm once more, the waves and spikes rising in stately predictability. They all wait, unwilling to rely on it, then Clare says: ‘OK, systolic rising: 80,’ and Satish breathes out. Charles says, ‘Good job,’ and Satish puts the paddles back.

Satish has rules about the stuff he takes. He always gets it straight from the drugs cupboard – a risky process but, he thinks, a more ethical one. Otherwise it’s a case of prescribing it for a patient and then taking it yourself, and you wouldn’t want to do that, not when it’s for anxiety and the kid’s preop and terrified, and won’t get any calmer because the diazepam’s safely tucked away in your case. Satish knows this because he did it once – only once – and it was so terrible that it became his first protocol. There are other rules: never increase the dose. Take it once a day, before bed.

By the time he’s reached his room again he already knows he’ll break this last commandment. He left the lab by a circuitous route, along intricate back corridors, rather than pass through the room in which Sarah was waiting. The benevolent influence of his earlier dose has long receded. He’s shaking, avoiding eye contact with the few people who are up and about, trying to control himself because his breath is juddering out of him. When he gets into his room he leans against the door to close it, then squats down, resting his forehead on his hands.

‘Oooh!’ he’s saying. ‘Oooh!’

He sounds like Maya did in early labour, like someone surprised by pain but breathing through it anyway. Sarah, and Louis, and that appalling, public melodrama. Her shouted apology, his privacy breached. He reaches into his pocket. By now, he can estimate his dose just fine, no need for a spoon, even. He takes a gulp, and then another. The taste of it is a promise: you’ll be OK soon. Wait it out. Her voice comes back to him, sorry. I’m sorry, and then he thinks of that other sorry: the quiet one, from Kawther just after she’d wished him luck.

What did she mean by that? Why should she think he needs
luck
? Does she doubt his abilities? Do others?

The thought fills him with panic, and then a sudden sadness comes. He wants to go somewhere safe, where he doesn’t need to protect himself all the time. But when did that last happen? When he was a kid, he thinks. In Cherry Gardens, before it all fell apart. With Cai. And Mandy – always with Mandy.

He thinks about Mandy, and he sleeps.

A few weeks before the Jubilee, Satish was round at Mandy’s house. They were playing Truth or Dare in her bedroom, Satish maintaining a courtly restraint (Dare: stand on your head. Truth: where would you most like to go on holiday?), Mandy being less scrupulous. He chose Truth twice and regretted it. (Which girl from school do you fancy? Have you ever heard your parents Doing It?) When it was his turn again, he risked a dare instead.

‘OK,’ she said. ‘Steal one of my mum’s cakes.’

‘What?’

‘Steal a cake for me. Go on.’

‘I can’t. It involves other people. Your mum. You can’t involve other people. It’s a rule.’

She stepped close to him. She smelled of Pears shampoo, the same stuff he and Sima used, but it was sweeter on her somehow, and stronger. When she spoke, quietly, next to his ear, he could feel her breath warm. ‘It isn’t a rule. You asked for a dare. Do it.’

Mandy’s mum was polishing the dining room table. They could see her from the kitchen, through the serving hatch. When she spotted Satish, she waved a can of furniture spray at him.

‘Hi, Satish. You all right?’

‘Yes, Mrs Hobbes. I’m getting a glass of water.’ He reached up to the cupboard, pushing the hatch door closed as he did so. Mandy, crouching below counter level, shot up a hand and re-opened it, wider than before.

The cakes were in front of the serving hatch. She’d made scones, their sides softly concertinaed, pasty-pale and studded with raisins, arranged in serried rows on the cooling rack.

‘I’m just pouring the water now,’ he shouted through, sloshing it into the glass. He waited until Mrs Hobbes had started on the bookcase, her back to him, and made it fast. It was a smooth operation: grabbing the scone, still warm, the flour gritty against his hand, dropping it to Mandy, who chomped into it straight away.

‘Mmm,’ he said. ‘Nice water. Thanks.’

They left the kitchen, Mandy rising once she was out of her mum’s sight.

‘Great dare,’ she whispered, still processing the last of her mouthful. Then she swallowed and whipped her arm behind her back; Mrs Hobbes was coming.

‘You down here too, Mands? What are you up to, then?’

Through the kitchen door Satish could see what he’d missed before. There had been twelve cakes: three rows of four. But now he’d nicked one, there was a gap; she’d see it immediately. He thought fast.

‘My glass!’ he said, holding it up, and went to put it noisily on the kitchen counter. He heard them talking in the hall.

‘We’re just mucking around,’ said Mandy. ‘Satish needed a drink.’

He tried rearranging the scones, leapfrogging replacements into the gap, shifting them around. Nothing worked.

‘Well, I’m done with the dusting,’ said Mrs Hobbes. ‘Done and dusted! Garden next.’

She’d have to go through the kitchen to get to the garden. She’d see the cooling rack, and then – he looked at Mandy, the remains of her scone behind her back – Mandy’d be for it. He put the scones back where they were, with the gap at the front, then he spread his fingers to widen it. When Mrs Hobbes came into the room, he puffed out his cheeks.