The late-night weather forecast predicted another hot day in a series of hot days that seemed to Anita Cornelius as if it would never end. The heat had kept her awake every night for weeks. Once again she had tried to get some sleep but ended up switching on the television, watching the news, and eating the last of the crackers her colleague from the day shift had left behind.
It had been a fairly routine night shift at the Hospital Am Urban ambulance station in Berlin. Anita and her assistant Maik had had three call-outs: one chest pains, one blood sugar, and one acute abdomen, all old people. That was how it always was, really, even in Kreuzberg, famed in the tabloids for stabbings and drug crime. Common is common, rare is rare: that’s what Anita had been taught back in her student days, and growing old was pretty common in this country.
Anita got up to get herself a snack from the vending machine at the station entrance. After inserting a coin and making her choice, she glanced at the row of chocolate and watched as a Mars Bar was pushed forward until it teetered on the edge, started to fall, and got trapped against the coil, which at that moment ceased to turn. Anita stared at the chocolate bar, wedged between coil and shelf over the abyss. A hospital where even the vending machine doesn’t work – how reassuring, Anita thought, and she’d have seen it as a bad omen, if she’d believed in such things. Which she didn’t.
Anita’s thoughts turned to her son. How many times had she stood here with Lukas, hoping the machine wouldn’t swallow up the last of her change and leave them empty-handed? When Lukas was little he’d even tried sweet-talking the machine to up his chances. Of course, now he was fourteen he didn’t do that anymore, he hardly ever visited her at work anyway, even though he now lived closer to the hospital than Anita herself, barely a hundred metres away, with Anita’s ex-husband and his new girlfriend.
Anita gave the vending machine a thump. She knew it was pointless, but did it anyway. She couldn’t accept that the machine wouldn’t release the chocolate, and was shaking it harder and harder when she heard a shriek sounding from her trouser pocket. The pager.
She looked at the display: Blue-light call: CAD1505 RTC 72 Skalitzer Straße 0:32.
* * *
“One male casualty, trapped. Alert. BP 120 over 80. Heart rate 90,” said the paramedic and pointed to the driver’s door with his free hand. “Luckily the window was open, so we got a collar on him and put a line in while we were at it. But it’s hard to get past the steering wheel.”
He sounded relieved to be handing over responsibility for the medical decisions. An accident like this was rare in the city. Standing close to the wreck, even Maik, never fazed by anything, was momentarily lost for words.
Anita counted to three in her head, something she’d learnt to do in difficult situations to calm herself down. She was afraid for the crash victim and afraid of making a mistake, but also felt a rush of adrenaline now that everyone was awaiting her instructions. She had to stay calm so she could think clearly. She could do it. She knew how. But this time it was different. She counted to five, six, seven, took a deep breath, and said to the paramedic:
“Right, let’s get to work.” She looked at the wreck and wondered what on earth you had to do to kill yourself instantly in one of these new cars. Then she looked inside and the emotions that she’d just suppressed were suddenly there again. A kid. She’d been convinced it would be an adult, a man, but the driver was just a few years older than her son: seventeen, maybe eighteen. Anita was always shocked when she saw a young person weak and helpless like this. She had to force herself to look.
He was thin and the neck brace made him look unnaturally stiff, more like a crash-test dummy than a person. His left arm hung limp out of the car window, as if pulled down by the little white clip attached to his index finger showing the oxygen levels in his blood – thankfully they were normal.
Anita ripped off the visor half hanging from the ceiling of the car, and pulled the limp airbag out as far as it would go:
“Hello, I’m the doctor. Can you hear me?”
She asked more out of habit than anything else. She could hardly hear herself speak: not far from her someone had just started up a generator and one of the fire rescue units was reversing and beeping loudly.
Raising her voice, Anita leant in and said “Are you getting enough air?”
The boy mouthed what looked like a ‘Yes’ and tried to look at her, as much as the neck brace would allow. Anita noticed his eye movements were synchronised. That was a good sign.
“I’m just going to have a quick look in your eyes with this light, OK?”
Anita lifted one eyelid and then the other. PEARL, she thought: pupils equal and reactive to light. If he did have a brain haemorrhage, it hadn’t yet caused any severe damage, although Anita considered a serious brain injury unlikely. There was nothing to suggest he had hit his head, no dent on the dashboard, the windscreen, or the steering wheel.
“Does it hurt anywhere, sweetheart?” Anita asked, automatically adopting a more maternal tone, having touched the smooth skin of his face as she checked his eyes.
Someone handed Anita a bigger light to illuminate the footwell. The impact had bent the clutch, accelerator, and brake pedal around his legs. Anita squeezed her arm between the steering wheel and the door and pinched the boy’s thigh.
“Can you feel that?”
She pinched him again, so hard that her fingers hurt.
“Can you tell me what I’m doing here?”
“No,” he said, and Anita saw there were tears in his eyes. Shock normally prevented this kind of reaction, but the boy seemed to grasp what it all meant. Seeing his fear, Anita remained calm and did what she always did in these situations: she stroked his head, lowered her voice and said in a reassuring tone:
“I’m going to look after you.”
And after what I’m about to give you, Anita thought, you’re not going to remember a thing. She turned to Maik:
“Load me up a ketamine.”
“Ketamine!” Anita almost had to shout, it was so loud around them, and now the U1 metro was rattling right over their heads towards the Spree. Ketamine. Anita and Maik used it because it worked fast and relieved pain completely, without affecting breathing. It gave patients a floating feeling, as if they were leaving their bodies behind, surely something anyone would want in this situation.
Maik handed her the syringe and said: “Do you want the midazolam now as well?”
Anita put the syringe into the cannula and gave the boy the painkiller followed by the sedative. It never ceased to amaze her how effective these drugs were, how the patient’s breathing became calmer with every breath. Within seconds the fear vanished from the boy’s eyes. She could hear a man next to her speaking loudly into a radio. He had his back to her, and she could read the words ‘Incident Commander’ on his uniform. She tapped him on the shoulder and said:
“Hello, I’m Dr. Cornelius.”
* * *
“I’m leaving the car here, once this is over. I’ve got plans anyway – we’re going out,” the boy said. His breathing was more laboured now the ketamine was wearing off. Anita switched on her light and took another look at her de-fib monitor. His heart rate was up, his blood pressure had fallen and she hoped things wouldn’t get any worse.
“How much longer do I need to sit here for, then?”
“We’re getting you out, we just need to take the roof off first.”
“Because your legs are trapped.”
He tried to move and Anita instantly regretted saying anything. There was a loud crack a few inches above their heads, like a huge bottle bursting. The boy flinched again. The firemen must have pierced the windscreen. The sound of sawing went on forever as they cut around the glass.
“I’ll walk home from the club. Promise,” said the boy. Anita nodded. As long as his breathing and blood pressure remained more or less stable there was nothing to do other than offer emotional support – a kind of professional hand-holding. So they sat there, the monitor beeping in a fast but regular rhythm. The heat of the summer night was stifling under the blanket. Anita turned the light back to his face. With the fireman’s helmet and small cut on his cheek, he looked more than ever like a little boy playing dress-up. What was he doing in a car like this? Had he stolen it? Had he borrowed it from his father, and if so, did he know? Or was this a typical first car for kids in Berlin?
“Do you remember what happened?”
“It’s crazy how hot it gets under a blanket, isn’t it? Me and my son always used to make dens out of blankets, we’d pretend to be cave explorers, with torches and walkie talkies. I’ve got a son – he’s fourteen,” said Anita. She just wanted to distract him, it didn’t matter what she said. She could’ve talked about the weather, as she often did, but for some reason she’d chosen to talk about Lukas.
“He’s too old for all that now. It’s scary how fast kids grow up, it seems only yesterday we were at the beach telling him to stay between the ice cream stand and the chip shop, and now the beach is Berlin and he’s allowed anywhere between Hermannstrasse and Alexanderplatz.”
A moment later the whole car started to creak. The sound grew louder, rising in pitch. The car shuddered, the roar of the diesel engine intensified and then there was a jolt, as if someone had caught the kerb too fast. They had cut through the A-post between the windscreen and the driver’s door, but the boy seemed oblivious. He didn’t even flinch.
“Almost there,” said Anita. There was a pause, then the boy said:
“I’d really like to go now … It’s too cramped in here and …” There was another pause. “And …” He stopped. Mid-sentence. The beeps coming from the monitor changed, they became more ominous – there wasn’t enough oxygen in his blood. Anita checked his blood pressure. It wasn’t good.
“Do you know where you are?”
“Talk to me,” she urged. At first it looked like he wanted to nod despite the neck brace, but then his head simply slumped forwards. The beeping grew deeper. And quicker. She felt his abdomen again – it was rigid. Anita changed tactics: Treat first what kills first.
This extract from Life Support (Arztroman) was translated from German at the 2015 International Creative Writing and Literary Translation Summer School, organised by the British Centre for Literary Translation in partnership with Writers’ Centre Norwich. The translators were Amy Bojang, Emma Clarke, Eleanor Collins, Alyson Coombes, Ben Fergusson, Laila Friese, Iwona Luszkowicz, Megan O’Sullivan, Helen Tatlow, Ayca Turkoglu and Peter Sean Woltemade, with workshop leader Katy Derbyshire and author Kristof Magnusson.