Authors: Maggie Hamand
She thought, I must do something to try to stop the bleeding. She knelt beside him, clumsily pulled out her shawl from under her coat, rolled it into a ball and unbuttoned Dmitry's shirt to see where he had been wounded. There were three small holes close together in the chest from which blood and air were bubbling and gurgling with each agonised breath. The lung must be punctured, she thought, all the bleeding is inside, oh God, he is going to die. Not knowing what else to do, she pressed the shawl over the wounds. As she did so he cried out and shuddered, making feeble movements to push her away with his right hand.
âIt's all right Mitya, I'm trying to help you,' said Katie in anguish and turned to look into his face. He was deathly pale and damp with sweat; his eyes were half open but did not seem to see her. He kept turning his head restlessly from side to side, as if by doing so he could escape the pain for an instant. Someone else had come to the door now; she could hear two or three voices outside. A man came and leant over her. âI've called the doctor; they say they know, they're on their way down,' he said. âCan I do anything?'
âYes, please do something, I don't know what to do, I think he is dying,' said Katie; her voice broke and she laid her head on Dmitry's chest in a gesture of despair, not caring that the blood stained her cheek and soaked into her hair. The man did not do anything; he watched her helplessly. âWhy don't they come, oh why don't they hurry up and come,' said Katie, lifting herself up and rocking herself back and forth; Dmitry was worsening by the moment, she could feel him slipping away from her. She did not dare let go of him or take her eyes from his face; she wanted to be with him, holding him, at the moment of death. She stayed as she was, pressing the blood-soaked shawl against Dmitry's chest, watching his face grow still paler, almost blue in colour, his eyes drift shut, and hearing the terrible sound of his distressed breathing.
The man beside her left abruptly; she heard footsteps running and the nurse appeared. She bent over the dead man and Katie cried, âPlease, come here.' She did not care about the other man; but the nurse had already left him, saying in a shocked voice, âHe's already dead. There's someone elseâ¦?'
The nurse knelt down beside her. She assessed Dmitry quickly, looking for any other injuries. She asked, âDoes he speak English okay?' and when Katie nodded, started to talk to Dmitry in a low voice, dispassionately, explaining what she was doing. First she put dressings over the wounds in the chest, taping them in place to make an airtight seal. Then she took Dmitry's left arm and folded it across his chest, holding it in place with a bandage. âI'm going to lift him up a little and turn him onto the injured side,' she said to Katie, âHe's going to choke like that. Can you help me?' Katie nodded; as they rolled him onto his side Dmitry started to yell, a terrible, deep, anguished sound; a sort of convulsion went through him and he struggled to breathe; blood was gurgling in his throat. âCough that up and spit it out,' ordered the nurse; Dmitry must have heard her and did so, and Katie watched aghast as a quantity of bright red, frothy blood issued from his mouth. She thought for a moment that this was the end, there was a moment of complete stillness; but after a brief pause Dmitry went on breathing, even more rapidly than before.
When they turned him over both Katie and the nurse saw that he was also bleeding, more copiously, from his back. Katie could not bear it; she must have exclaimed at this outrage, but the nurse said, as if reading her thoughts, âIt's an exit wound.' She tore the shirt away, covered this wound too and then asked Katie to support his head and shoulders to raise them from the floor. Katie did this, kneeling in the blood and resting his head in her lap; she would have done anything to help him live. The nurse smiled at her reassuringly as she reached for the oxygen cylinder.
But Dmitry coughed again and retched violently; he flung back his head, his lips pulled back in a dreadful grimace, the teeth gleaming grotesquely through the blood. The nurse put the oxygen mask over his face and said, âThis will help you breathe. Take deep breaths, more slowly. That's right, you're doing well.' Her voice was soothing, calm. âTry to keep still now, we're doing what we can, the ambulance is on its way. We'll get you to a surgeon very quickly now.' She looked up at Katie, with no expression on her face; she did not try to reassure either of them that he would be all right, and Katie did not dare to ask. Then the doctor came in, with another man. He paused by the body for an instant; the nurse said, âThis one is still alive. He's been shot several times in the chest; I've sealed the wounds, he's breathing a little better now. I'll take his blood pressure; can you set up the drip?'
The doctor came over, putting some equipment down on the floor. He turned to Katie and said, âPlease, let us take over now,' but she relinquished her hold on Dmitry only reluctantly, moving back against the wall. She felt dizzy; she thought she was going to faint; she leaned against the wall and shut her eyes for a moment, but she had to open them again and keep on looking, as if only by her watching and willing him to be all right could he be kept alive.
Dmitry's breathing seemed to have steadied now. The doctor held his right hand; Katie was struck by the care, almost tenderness, with which he stroked the inside of his arm, looking for a vein in which to insert a line and set up a drip. He had trouble getting the needle in; gentleness gave way to brute force, he was swearing to himself; finally he had to take a scalpel and cut down to a deep vein. The nurse talked to Dmitry while it was being done in her low, gentle voice. The doctor bandaged the arm and stood up, holding the bag of serum in one hand, and with the other picked up the telephone and dialled a number. After a moment or two Katie realised he was phoning the hospital; he was asking whether they had a surgeon available. He would have to be there immediately, she heard him say; there wasn't much time. Then she heard him saying, good, good. He hung up and turned to the nurse. âHe'll go to the Lorenz Böhler, they have a cardio-thoracic surgeon there right now,' he said. âThe ambulance will be here in a few minutes. How is his blood pressure?'
The nurse muttered some figure, then added, âIt's still falling.' She pumped the bulb up again; Dmitry suddenly coughed again, moaned and shuddered. She took his hand. She asked quietly, âMorphine?' but the doctor shook his head. He said, âIt won't be long. He's coping all right, better not to give him anything. He'll be at the hospital in ten or fifteen minutes.'
A silence fell over the room. It seemed nothing more could be done; Dmitry seemed to be drifting into unconsciousness now, his eyes were shut, he was quite still. Though this frightened Katie, she thought at least there would be no more pain. The nurse asked gently, âCan you hear me?' and his eyelids fluttered. Katie heard a familiar voice outside in the corridor; it was the DG, Seppo Kaisler. He came into the room. He said, âThe police have been called. No-one is to touch anything here. Who is it that's been killed? How is Mitya Gavrilov?' And then the question Katie had been afraid to ask, âWill he live?'
The doctor made a gesture with his hand as if to say that it was touch and go. Kaisler said, âDo everything you can,' and went to the door where a group of people had gathered. âGo home or get back to your desks,' he said. âYou can't do anything. Please move away now. Anil, come with me; I want to agree a statement for the press.' He turned back to the doctor. âTell the hospital I want to be kept informed; they can ring me any time, even at three in the morning. Where are they taking him?'
They continued to talk in low voices, but Katie didn't hear any more; she was suddenly overcome with fear. It occurred to her that Dmitry might never regain consciousness; she felt as if she had lost him already. It seemed an eternity, but could only have been a few minutes, before she heard more footsteps and the ambulance crew appeared. After a brief exchange with the doctor, they lifted Dmitry carefully onto the stretcher, lying on his left side, and carried him towards the lifts.
Despite Kaisler's efforts, a small crowd of people were still standing in the corridor, watching with astonishment and disbelief. Katie stayed beside the stretcher as they negotiated it into the lift. She clung to one of the ambulance men, terrified that they might leave her behind and take Dmitry away from her. They emerged from the building into the rain; the ambulance stood on the bleak circular concourse, its headlamps shining into their eyes and the blue light flashing on the wet ground. Katie pleaded, âI have to stay with him, please let me come,' and while no-one replied to her then, once the stretcher was safely stowed they helped her wordlessly into the ambulance. The doctor came in with her; the doors slammed shut and in seconds they were moving rapidly through the night, the vehicle swaying around the corners, the siren sounding.
She felt the vehicle accelerate as they swung onto the motorway; she knew the hospital was little more than a five-minute journey away. Katie clung to the seat, watching the two men check Dmitry's pulse, blood pressure, breathing rate. Her eyes were fixed on Dmitry's bloody chest, watching it rise and fall almost imperceptibly. Suddenly the phrase, âDead on arrival,' came into her head; she could not shake it out again, it repeated itself over and over in her head. The doctor and the ambulance men were watchful, tense; she watched them putting another bag of clear fluid on the drip-stand.
The ambulance slowed down, went round two or three sharp corners and lurched to a halt; the doors were flung open, the stretcher lowered onto a trolley. Katie scrambled out after it through the doors into the brightly lit basement of the hospital. She noticed the pattern of large red dots on the vinyl floor which led from the entrance to the lift, like a trail of blood. They wheeled Dmitry into the lift and the door slid shut behind them; Katie had to follow, running, up the stairs. As she came up onto the landing a doctor in white with thin, fair hair and pale blue eyes was standing by the trolley; two more doctors and a nurse seemed to swoop on Dmitry; they turned him over and his arm fell outward, heavy, lifeless. The movement struck terror into Katie. Under the bright lights his face was the colour of candle wax; his nose and cheekbones seemed sharp and thin as if the flesh had shrunk away from them; for a moment Katie thought that he was dead. Someone else must have thought the same, because she heard someone ask, âIs he alive?' and the doctor replied, âJust about.' Someone asked, âWhat's the blood pressure?' and another replied. âNot recordable.' The nurse was busy cutting off his clothes.
âAll right,' said the surgeon, âLet's get going with this. Get him in the emergency room.' Somebody asked him a question and he said, firmly, âThere's no time.' She heard him giving instructions, snatches of them reached her ears; each one of them filled her with horror, as if they were nailing her slowly into the floor. âRight, emergency thoracotomy⦠I'm going to open him up straight away. I'll want him ventilated⦠Prepare for intubation⦠venous lines⦠Put him in the left lateral position⦠We need uncrossmatched blood and saline â¦'
Katie could see them through the open door pulling open a metal cabinet; a doctor yanked at the seal to open it and started to pull out the emergency equipment; there was an atmosphere of intense concentration and controlled haste. A woman dressed in a white housecoat came to her side and said firmly, âPlease come this way, you don't want to watch this.' Katie pushed her away violently and continued to stare at what she could see happening through the open door. The woman firmly took hold of Katie's arm; âPlease, you must come with me,' she said. Katie did not want to move; she wanted to stay with Dmitry, to see everything that happened to him. Then they shut the door. Some kind of cry, as if it was herself who had been wounded, came from her mouth, and she thrust her fist into it to try to silence it. She was led downstairs into a room with two tables and chairs and a glass screen behind which the admissions staff sat, and asked to sit down at the table. Katie sat, her hands neatly folded in her lap, and stared at the table-top. She seemed to sit there like this for a long time. Then she looked at her hands. They were covered with blood, but the blood had all dried now, it was no longer that bright rich colour which had so astonished her. If he dies, she thought, I will never wash my hands â this is all I will have left of him.
âWould you like to drink something?' asked the woman. The voice made Katie jump; she had forgotten she wasn't alone. âNo,' Katie said, âNo, please, nothing.' Then she looked the woman straight in the eye and said, âIs he going to die?'
âIf he gets through the operation, he'll have a good chance. A chest injury like this is very serious, but many people survive worse. You must keep calm, you may have a long wait.'
Katie hardly listened; she knew the woman could give her only vague words of hope, committing herself to no opinion; and anyway, what did she know about it, she was not God. The woman went out and Katie was left alone. She sat in the silent room for what seemed hours. Katie felt a sudden hatred for God, if he existed; if Dmitry dies, she thought, I will hate you forever. It had the intensity for her of some irrevocable curse; she felt blinded for a moment by despair, hatred, and fear. How foolish she was to have hope; he had been shot several times; she had seen the surgeon's look of doubt; probably he was dead already. While some people clung to hope, refusing to admit that death was certain even in the face of irrefutable evidence, Katie had to prepare herself for the worst, pushing all hope into the furthest corner of her mind. In an instant she stood up, opened the door and started to run up the stairs. The nurse saw and tried to stop her, but Katie was too quick; she opened the door to the emergency room but no-one was in there. The floor was littered with discarded sterile wrappers and there was a lot of blood.