No.
He must have died instantly, Emma thought, sickened beyond belief. A little boy, seven or eight…
Bright copper hair.
Dead.
She swallowed and swallowed again. Katy had said his name was Kyle.
Kyle.
She was crying now. Tears were sliding uselessly down her cheeks and she couldn’t stop them. She didn’t try.
‘Kyle.’ She whispered his name, then put her hand across to touch the little boy’s face. His face was almost untouched but the rest of him…No. She checked for a pulse, but it was no use. She was searching for something she knew had irretrievably gone.
Useless.
Her touch turned into a tiny gesture of blessing. It was all she could do for him.
Doctors should grow accustomed to death.
Doctors never did.
Two kids. She had to move on. Katy had said there were two kids. She swiped away the useless tears and went on searching.
Where…? Had someone been thrown out?
Where?
‘Suzy?’ she called.
Nothing.
She was reaching the front of the bus now, the lowest point—checking, checking.
And then she heard…
It was a rasping, choking sound, so slight it had been almost lost in the sounds she herself was making as the broken glass crunched under her.
Where had the sound come from?
Further forward.
Here.
She paused, staring down in horror.
Suzy.
The little girl had been hit. Not like Kyle—she hadn’t been completely crushed. But the log had slammed against her face.
Her eyes were OK. She was staring upward, frantic. Caught between two seats, she hadn’t been able to call for help.
Of course she hadn’t. It was all she could do to breathe, Emma realised, sliding down so she was right against her. Every breath was a gurgling, gasping attempt to gain enough air to survive.
She was failing. There was a dreadful hue to her skin, which was mute evidence that her efforts weren’t enough.
The log had smashed her cheek, her mouth, her throat. The damaged flesh would be swelling, making breathing more difficult every second.
‘It’s OK,’ Emma told her, catching her hands and trying to sound assured, not panicked. ‘You’re OK, now, Suzy. I’m a doctor. I’m here to help you breathe. It’s OK.’
The child stared wildly up at her, her eyes reflecting the terror that Emma felt.
And then, as if she’d held on for long enough—for too long—she fought for one last dreadful breath and she slipped into unconsciousness.
No.
Unconsciousness meant death, Emma thought desperately. Without fighting, how could Suzy get air past the damage? How could she get the oxygen she so desperately needed?
Emma slipped her fingers into the little girl’s throat, frantically hoping that she might find loose teeth or bloody tissue that could be cleared. What she felt there made her lift her fingers back in despair. It wasn’t just loose teeth or blood blocking the trachea. This was major damage. Air wasn’t going to get into these lungs via the child’s mouth or nose.
What next?
The guy outside had a doctor’s bag. He’d have a scalpel, maybe a tracheostomy tube…
No. It’d take too long to call—explain—get the bag in here. The child was dying under her hands.
She had seconds.
The breathing was a rasping, thin whistle, each one shorter than the last. The little girl’s body was convulsing as she fought for breath.
The fight was lost.
She had to do something now! She stared wildly round. What? Anything. Anything.
A child’s pencil-case…
She hauled it open, ripping at the zip so hard it broke. What? What?
A pencil sharpener. A ballpoint pen.
She hauled them out, sobbing in desperation. Maybe.
She had her fingernail in the tiny screw of the sharpener, twisting, praying, and the tiny screw moved in her hands. In seconds she had the screw out, and the tiny blade of the sharpener slid free into her palm.
She had a blade. A crazy, tiny blade but a blade. Dear God. Now she needed a tracheostomy tube.
She hauled the ink tube from the ballpoint.
OK, so now she had basic equipment. Sort of.
How sharp was her blade?
There was no time to ask any more questions. It was this or nothing. Suzy was jerking towards death.
Go.
And in seconds it was done—the roughest, most appalling tracheostomy Emma was ever likely to see, ever likely to perform, in her life.
Where was her medical training now? Was she mad?
To cut an incision in Suzy’s throat with a rough blade from a pencil sharpener, to insert a ballpoint casing that still had ink stains and teeth marks on the end where its owner had thoughtfully chewed while doing his schoolwork—how could it possibly work?
But wonderfully, magically, it did. Within seconds of the ballpoint casing entering her rough incision site, Suzy’s breathing rerouted through the plastic.
The awful, non-productive gasping ceased.
The child was still unconscious but her breathing was settling to a rhythm. The dreadful blue was fading.
She’d done it. She relaxed, just for a moment.
The bus shifted, lurched, and she forgot about relaxing.
For a moment she thought they’d plummet together and all she thought was, What a waste. What a waste of a truly amazing piece of surgery.
She’d succeeded, she thought wildly, terror and jubilation crazily mixed. Suzy could live. There was no way this bus could plummet now.
‘Let’s just keep really still,’ she told herself. Not that she had a choice. She was holding the ballpoint casing right where it had to be held. If she moved, Suzy’s breathing would stop. As simple as that.
She couldn’t move.
The little girl’s eyes flickered open, and Emma put her spare hand on the child’s forehead to stop her jerking as she regained consciousness.
‘Suzy, you’re fine. But you mustn’t move. I’ve put a tube in your throat to help you breathe but you mustn’t move an inch. Not an inch.’
The child’s eyes widened.
Emma was right there.
‘I’m not moving either, Suzy,’ she told her. ‘We’re stuck on the bus and we’re waiting for someone to come and get us out. Who do you think will come first? I’d like the fire brigade. Wouldn’t you? All those bells and sirens sound great, and I love firemen’s helmets.’
Suzy’s eyes said she was crazy. Maybe she was crazy.
‘What shall we do while we wait?’ Emma continued, still holding Emma’s