The secret in his eyes
It was a night unlike any other. The A&E had been practically empty, almost unheard of in all the years that Steven had been working there. No drunks filling the place, the bad weather kept people out of the pubs. They would have expected some car accidents in these conditions but everything was still. It didn’t do any of them any good and they tried to occupy their time taking care of paperwork that had been allowed to build-up. Still, it was hard to remove the sense of foreboding that was lingering around the A&E, as if fate was planning something special for them.
About two hours into Steven’s shift there was a call at the office, there had been a crash out in the country roads, an ambulance was incoming. As details poured in, Steven and the rest of the staff prepared as well as they could for what was coming. He had seen many car crashes coming through those doors over the years so he knew it was going to be gruesome. Even those that survived ended up with horrific injuries, Steven had to steel himself.
The ambulance arrived at the entrance and Steven and his team got to work. It was a single car accident, two occupants, a man, about thirty and a boy about seven, presumably his son. The boy had not survived the crash. But as there was no doctor riding shotgun, he had to be brought to the hospital to be declared. They left him in one of the empty treatment rooms to deal with later while the team got to work trying to stabilise the man.
His chances were grim, severe trauma, numerous broken ribs bones, possible fluid on the lung, and most troublesome, the pupil response was altered, possible indication of a brain bleed, fatal if not treated. They inserted a shunt to drain as much fluid as possible from the lung and aid breathing, then sent him down to radiology, for an x-ray and hopefully answers for what to do next. One of the other doctors called the surgical registrar and gave him the patient details, if the X-ray was positive then the surgeons would have to operate as fast as possible. It had taken Steven and his team not more than twenty minutes for all that, the man was no longer in their hands.
As the rest of the A&E staff went about the rest of their duties, Steven and an intern, Jenny who needed the experience went into the empty treatment room.
The death of a child is usually an unnerving experience for a doctor, especially their first time, Steven expected her to have difficulty at least. But if you wanted to be a doctor then you have to take the good as well as the bad. Still Jenny had Steven with her. Who did Steven have?
The walked together into the examination room. There, on the bed, lay the still body of the boy. His face was greyish, blue lips, darkened eyelids and the eyes, the eyes, open to the world. It was a sad scene and Steven was almost unwilling to enter the room. They stepped in together and Steven began his examination, to check that the boy was dead. Pulse, looking for heartbeat, breath sounds and pupil response.
He was looking over the body, jenny at his shoulder, when the door opened and one of the nurses, Frances stuck her head in. “James told me to tell you that they found two bleeds in the patients brain, McCluskey and Smith are scrubbing up, they say that they’ll do what they can.”
Two bleeds, in the brain, the outlook was grim. McCluskey was good, but he couldn’t do miracles. Not a good day at all. He started up his examination again. The body was pretty beat-up, that would be expected from a car crash. He could hear Jenny sniffling behind him, all in all she was taking it pretty well, had the makings of a fine doctor. “It doesn’t look real” She said “I thought he would look more alive”. Steven found it remarkable how often interns had preconceptions. “The patient is dead Jenny! You would expect him to be somewhat lacking in life.” Still, as Steven finished his examination he did seem to find that was something odd about this body. Something seemed off. The colour was wrong. Jenny could see that he was puzzled about something. “Is there something wrong doctor?” Steven went back over what he had been saying “How long ago was the car crash?” Jenny checked over the notes that she had one her “Crash was reported at 10:30 might have happened ten to fifteen minutes before that… about and hour and a half ago. Why?”
Steven pointed at the bruises on the boys arm. “Look at these” He poked a large bruise “Note how they feel. there is no swelling on this bruise, isn’t that odd?” Jenny looked on, a confused look on her face. Steven pressed on “If I was to give you a thump, you will bruise, right? There will also be some swelling as the body reacts to the injury.” He pointed again at the body. “There is no swelling here.” He moved his hand over that arm and the other one “Or on any of the limbs. Do you know how the body was handled at the accident scene?” Jenny seemed to be grasping what was being suggested “They seemed to be respectful. No serious manhandling when he was brought it in. Are you suggesting that they were too rough?”
“What I am saying that these injuries were not made on a living person and unless the paramedics kicked him around before they shipped him to us then the they could have only have come from the crash.”
The young intern seemed taken aback by the suggestion “Are you saying that he was dead when the car crashed?”
Steven looked her in the eye and said “If you can explain it better, then I would like to hear it.” He leaned over the boys face, there was more bruising there, around the eyes, still open. He looked straight into them “what secrets do you hold?” he whispered.
Jenny was about to asked he had said when he called her over. His fingers where on the boys neck, feeling around the throat, “How bad a case of whip-lash would you call that?” He prodded the windpipe, it gave way. “Oh my god!” Jenny whimpered, “Could the crash have caused that?” Steven was doubtful “I have never seen it. Maybe if the seatbelt was around his neck. But there is a lot of ifs about that.”
“Are you saying that the boy was strangled? Should we tell someone?” Steven held up his hand. “That isn’t our job. Pass me the death certificate, please.” Jenny nervously passed on the form and as he filled it in, he made sure that she could see how he filled in the cause of death section ‘Unknown, recommend autopsy’. As he gave the form back he told Jenny “If we could spot these, then Jones will in a heartbeat and more” referring to the hospital pathologist, “He’ll take it from there.”
Steven and the intern then left the room and called in a porter to transport the body to the morgue. The night picked up quite quickly, six idiots had injured themselves trying to night cycle and needed to be stitched-up, there was also a toddler who had drunk some cleaning fluid and had to get his stomach pumped. Pretty basic stuff but kept his mind off what he had seen.
At two in the morning, news came from upstairs. McCluskey and smith had tried their best but the damage had been too great, the man had died on the operating table. The Gardai had made an identification and were trying to track down his wife and tell her the bad news. “That is only the beginning” Thought Steven.
The rest of the night passed quickly enough and at six in the morning, Steven signed out and made way for the day shift. As he was changing in the locker room. He spied Jenny sitting on a bench, she had been crying, he placed a hand on her shoulder and as she looked up, nodded. It was small comfort but it made her smile, someone else understood.
As he drove home from the hospital and for some time after. Steven’s mind kept on going back to the boy, his name he had found was James O’Reilly, and to his eyes, open, dead, and filled with secrets. Just waiting to be revealed.