‘I don’t want the tube.’
‘Then you have to drink the charcoal.’
Mia had taken an overdose and to stop the tablets from being absorbed further, she had to be given a large drink of activated charcoal. It looked terrible, it was black and chalky, but as Penny and Vanessa had told the patient over and over, it actually didn’t taste too bad. It was all to no avail, though—despite a lot of coaxing they’d only managed to get half the liquid into Mia.
‘If you can let me put this tube down your nose and into your stomach, we can put the rest of it down and you won’t have to taste it,’ Penny said, ‘and then you can have a rest, but it’s imperative that you have the charcoal.’
‘I can’t.’ The poor girl was upset already—after a huge row at her boyfriend Rory’s house she’d stupidly swallowed some pills and when she’d got home her parents had thought she’d been drinking. When Mia had finally admitted what she had done, before calling the ambulance, there had been another row for Mia with her parents shouting at her, even as the paramedics arrived.
They’d started shouting again when Rory had arrived at the hospital, when most of all Mia needed calm, and Penny was doing her best to ensure that Mia got it, but first she had to get the charcoal in.
‘Do you want Rory to come in?’ Penny suggested. ‘He offered before.’
Mia nodded and Penny called the young man in. At eighteen Rory was very mature and he held both Mia’s hands as Penny got ready to have another go at putting the tube down.
‘Big breath,’ Penny said, ‘and then start to swallow when the tube hits the back of your throat.’
Except she didn’t swallow. Instead, Mia vomited all over Penny’s gown, so much so that it soaked through to her clothing.
‘It doesn’t matter,’ Penny said soothingly as Mia started sobbing her apology. ‘Let’s give it another go.’
The cubicle looked as if someone had been playing with a black paintball and the staff and patients didn’t look much better either, but finally the tube was in. Penny checked its position, relieved that the tube was in the right spot.
‘Right, let’s get the charcoal in and then you can have a rest.’ The medication was poured down and Penny had a word with the intern, Raj, before she headed to the changing rooms. She was incredibly tired and couldn’t wait for the couple of hours till the end of her shift.
Penny kept a spare set of clothes at work, but it was five a.m. and she was past caring so, rarely for her, she pulled some scrubs off the trolley, filled the sink with water to try and soak her shirt, and it was as she did so that Penny felt it—a cold feeling down below. She wanted to be imagining things, wanted to be wrong, so she dashed to the loo, but as she pulled down her panties it was confirmed that, no, she wasn’t imagining things.
‘Please, no,’ Penny begged as she sat with her head in her hands, trying to tell herself it was normal, just some spotting, that it wasn’t her period she was getting.
Penny couldn’t stand to call it a baby; it was the only way she had been able to get through it last time. So she told herself that it was just a period, said over and over to herself that most women wouldn’t have even have known that they were pregnant at this stage.
Except Penny knew that she fleetingly had been.
‘Penny!’ She heard Vanessa come into the changing room.
‘Can I have two minutes?’
‘Mia’s not well.’
‘I’m on my way,’ Penny said through gritted teeth.
‘She’s seizing,’ Vanessa went on.
‘Then what are you doing in here, talking to me?’ Penny shouted. ‘Put out an urgent page for the medics.’
As Vanessa fled, with shaking hands Penny had to find change to buy a pad and then pulled on scrubs and dashed back to Mia. Raj was there and had given Mia diazepam; she had stopped seizing but was clearly very unwell.
‘She’s taken something else,’ Penny said, because the medications Mia had admitted to taking would not have caused this.
‘I’ve just spoken to the family.’ Vanessa’s voice was shaky. ‘The boyfriend’s ringing his mum to go through all the bins and things as they were at his house when she took them.’
‘Good.’
Penny was tough, she had to be tough, she just didn’t let herself think about personal things; instead she focussed on saving a sixteen-year-old girl who had made a stupid mistake that might now cost her her life. As soon as Rory came off the phone she spoke to the distressed boyfriend to try and get more clues as to what Mia might have taken.
‘Mum’s on anti-depressants.’ Rory looked bewildered. ‘I didn’t even know that she was, but she’s had a look and one of the packets is missing. She thinks—’
‘Okay, what are they called?’
He told her and Penny kept her expression from reacting—she didn’t want to scare the young man any more than he already was, but tricyclic antidepressants were very serious in overdose and could cause not just seizures but cardiac arrhythmias.
Leaving Rory, Penny told the medics what the young girl had taken and then dealt with the parents, who were still blaming the boyfriend.
‘He has been very helpful,’ Penny said. ‘If it wasn’t for Rory, we wouldn’t have known what Mia had taken, and he also helped us to get the tube down. Mia’s actually had the right treatment—the charcoal will stop any further absorption, but she’ll need to go to Intensive Care for observation.’
‘When can we see her?’ the father asked.
‘I can take you in there now,’ Penny offered, because Mia was awake now, though very drowsy, but first she just wanted to clarify something with the parents. ‘I know you’re very upset at the moment, but it has to be put aside for now. Mia needs calm, she is not to be distressed.’ Penny looked up as Rory walked in.
‘What the hell did you say to upset her enough to take all those pills?’ the father flared. ‘You caused this.’
‘I’m sorry!’ Penny stood. She’d heard enough. ‘Until you calm down, you’re not coming in to see Mia.’
‘You can’t stop me from seeing her.’
‘Absolutely I can.’ Penny stood firm. ‘Mia is to be kept as calm as possible. We’re trying to prevent further arrhythmias or seizures, not actively bring them on.’
She walked off and started writing up her notes, and finally a rather more contrite father asked if he could go in and see his daughter now, assuring Penny he would not cause her any further distress.
‘Of course.’
She stepped behind the curtain to have a quick word with Vanessa before letting them in.
‘Mia’s parents want to come in,’ Penny said. ‘Don’t take any nonsense from the dad if he starts getting angry. Just ask him to leave.’
‘I don’t take nonsense from the patients and their relatives,’ Vanessa said, and as Penny turned to go she heard the nurse mutter, ‘I’ve got no choice with the staff, though …’
Penny didn’t have the time, let alone the emotional capacity, to respond to Vanessa, or even to dwell on it. She had no alternative other than to drag herself through the last part of her shift, then she got into her car and finally she was home.
Penny took off her scrubs. Her stomach was black from the charcoal and she showered quickly then put on a nightdress and picked up the phone.
‘I’m bleeding.’
The IVF nurse was very practical and calm and, yes, a bit of spotting was normal, but this was more than a bit of spotting and they went through the medications, but Penny could feel herself cramping.
‘Should I rest?’ She wanted to ring in sick but she knew deep down that it wouldn’t make any real difference.
But she rang in sick anyway.