When the baby is wheeled into the emergency department, it becomes clear that he is a drowning victim. It is February. There is no snow on the streets, but the sky hangs low with heavy, leaden clouds that seem to warn of the tragedy unfolding. A siren wails outside as a rescue ambulance pulls up to the hospital entrance.
Looks like theyve brought in someone heavy, given how loudly the vehicle is announcing its arrival, a senior surgeon mutters, his voice tinged with irony.
The doors of the ward swing open and a chorus of voices erupts in the corridor:
Come on, open the door, get him in here!
The emergency room door bursts open, and a man carrying a baby on his hip steps inside. Close behind him, a woman clutches her head with both hands, her face ashen. She cries out, Is he alive? Please, tell me hes alive!
I am on call as a trauma surgeon, working on a weekend. I dislike being on duty on my day off, but during the week time rushes by quickly, and the staffdoctors, lab technicians, radiographersare all on hand, so questions get answered faster.
Where should I take him? the father asks, his voice cracking. Help me, youre a military doctor, you can do something He begins to sob.
Everyone snaps to attention.
Place the child on the trolley, now, the senior on shift orders sharply, Trauma surgeon, examine him, and call the intensive care team to be ready.
I stare at the infant and feel a chill run through me. A year ago I was on a similar shift. It was December, snow blanketing the streets of Manchester, when a frantic mother arrived looking for her son who had vanished after a trip to the park with a sled. After hours of searching we discovered the boys body buried in a shallow ditch, still in the same blue jacket and red beanie he had worn. He was the same age as this child.
How long ago did you find him? I ask the father.
I dont know, he replies, Neighbours found him floating in a ditch, still showing signs of life. They gave him artificial breathing in the ambulance
Alright, step aside, colleagues, I say to the team, Focus on the child.
I remove the babys hat and unzip his jacket. His face is bluish, pupils are wide and unresponsive to light, and there is no pulse or breath.
Was water removed from his lungs?
It seems not.
We begin manual ventilation, filling his lungs with air. I turn him onto his stomach, press my knee into his back and give a firm thrust. Water bursts from his mouth. I place him on the trolley, give a forced inhalation, then compress his chest three times to stimulate circulation.
The cold night makes me wonder if the brain might still be viablethere are cases where people trapped in avalanches survive for days. Minutes tick by on the wall clock: two, three, five. Suddenly there is a faint murmur, like a kittens purr. The baby lets out a loud, adultlike gasp, as if fighting his way out of deaths grip.
Take him to intensive care, we need to switch him to controlled ventilation; he wont be able to breathe on his own, I shout.
Alison, is he alive? the mother, who has been silent until now, asks, her voice trembling. Doctor, is he really alive? Are we saving him?
Now we hope, a colleague answers, We need to call the air ambulance for paediatric intensivecare support.
We carry Thomas on a stretcher to ICU. The room is hushed, the monitors soft beeps and the flickering of the bedside lamp are the only sounds. The ventilator works tirelessly, keeping his tiny body alive. His narrow, skyblue eyes keep flickering, a sign that his body is still fighting.
The airambulance team arrives two hours later. After examining him, they give their verdict:
The child is not viable; the brain has suffered irreversible damage during the period of clinical death. Disconnect the ventilator and await the outcome.
A stunned silence falls over the staff.
Our paediatrician steps forward, voice shaking, If his pupils react to light, his brain is still functioning.
The pupils are dilated and unresponsive, but how long was he submerged? The presence of water in his lungs suggests the resuscitation in the ambulance was ineffective. Hes already developing nonreversible changeskidneys have failed
I cut him off:
Lets try something else. We dont have a paediatric catheter on hand, but perhaps you do?
The team nods, Well give it a go.
They fetch a thin paediatric catheter and attempt insertion. As soon as the needle pierces his skin, a spray of bright yellow fluid erupts, splashing the exhausted team.
Hes alive! Hes alive! we exclaim in unison.
Lets stay a few more hours, then well wean him off the machine. If he breathes on his own, well take him home.
Three hours later Thomas is stable enough to be transferred back to the ward.
Two years pass. The incident with Thomas becomes a memory that haunts me. One Saturday, as Im leaving the clinic, a man knocks on my door. He looks oddly familiar.
Do you know me? he asks.
Im sorry, Im trying to remember did you ever treat me, or did we work together? I answer, puzzled.
You dont remember this boy?
From behind him a smiling childs face appears. Its Thomas, now older, his hair a mess of curls.
Its you, Thomas, I gasp.
Yes, its me. Alex, come and say hello to your saviour. Sorry we disappeared for so long. We got lost after the rehab year, couldnt find your address, and you were always travelling. At least were here now, and you can let us in.
Come in, of course, I say, still in shock.
Thomas runs around the room, reciting poetry, examining my shell collection, holding each piece to his ear as if listening to the sea.
Dad always said you must learn to swim, or youll drown. Can you swim? he asks suddenly.
Of course I can, I reply, surprise lacing my voice, Happy swimming, lad.
I now work as a surgeon at a city health centre. During a routine health checkup, a tall, impeccably dressed officer in a navy uniform approaches me.
Good afternoon, Dr. Michael Turner, he says with a deep, smooth baritone, Ive long wanted to meet you.
Good afternoon, Captain James Whitfield, I reply, glancing at his service record, Do we know each other?
More than you think.
I study his face; something familiar flickers in his bright blue eyes.
Michael? Thomas? I ask hesitantly, Is that you?
Yes, its me. Ive just returned from the Royal Marines Academy and tracked you down. Your wish has been granted. Im a naval officer now!
