The End of Men. Christina Sweeney-Baird

children is something that affects him as much as it does me?

      The thing is, Anthony is asking me to do something I cannot do. I cannot make a decision on this. A significant part of me hopes, secretly, that it will just happen. If we keep waiting and pushing it off for another month, and another, and another, maybe this month will be the one. I fell pregnant with Theodore after six months of entirely enjoyable regular attempts at baby-making, and just as I was starting to panic there it was. Morning sickness so bad it could have felled a horse. I know it’s been two and a half years of trying with no success. I know that my egg reserve isn’t great and my uterus is a weird shape that makes it less ‘hospitable’ to an embryo (a word so cruel, in the context of fertility, that I wanted to strangle the haughty consultant insulting my anatomy with his tie). I know all of these things and I wish I didn’t. I wish we could be ignorant and hopeful because it might happen. We just don’t know yet.

      That night, passing the photos of us on my way up the stairs, I marvel, as I often do after our fertility conversations, at this thing we’ve constructed. A family from the ground up. From the photo of us in our first year together, limbs easily entwined in the College bar, gazing at each other, to the photo of the three of us Phoebe took a few months ago in Battersea park. My dark curls flying in the breeze contrasted with Theodore’s perfect chestnut mop inherited from Anthony.

      Later, I’m lying in bed reading. Anthony climbs in after me and I fall into our routine. My book to one side, I pass him his eye mask, light off, my head on his shoulder, my arm on his chest, his hand on my elbow, safe.

      ‘Anthony,’ I whisper.

      ‘Yes,’ he replies. I love this about him. He doesn’t say ‘what’ or even ‘hmm’. He says yes to whatever I might want to say.

      ‘I don’t want to make a decision. I can’t.’ A lump is in my throat. I rarely cry now about our years of infertility. I try to swallow it down because really, you cannot spend every night crying for two years. It’s too depressing for words. ‘What if it happens naturally? I want it to—’

      ‘Oh Cat,’ Anthony says softly and his voice undoes me. By revealing it, my secret has lost its power. It’s a sad, small, silly hope. And yet, who knows?

      ‘I understand,’ he says. ‘We’ll give it one more month.’

      In that moment, I have never loved my husband more.

OUTBREAK

       Amanda

       Glasgow, United Kingdom Day 1

      November is always busy but this is ridiculous. The area around Gartnavel has never shown its divisions more apparently. The ice-induced falls and chesty coughs of Glasgow’s polished, middle-class West End residents appear in A&E in a flurry of expensive highlights, knowledge of different kinds of antibiotics and clipped accents which make clear they want their parents and grandparents to be seen now. The other side of this tale of two cities is liver cirrhosis, chronic poverty and the unglamorous side effects of a life of smoking.

      ‘It’s another SLS,’ Kirsty, an excellent young nurse, says gaily as she swings past me, unceremoniously plonking a chart into my arms. Shit Life Syndrome. Doctor speak for, ‘There’s actually nothing wrong with you. You’re just really sad because your life is really, really hard and there’s nothing I can do about that.’ I used to try and help, little naive waif that I was. What if they have nobody else? I would think desperately to myself, as I phoned social services seven times in one night until they stopped answering me. As a consultant, my approach is a bit different.

      ‘Why am I seeing them then?’ I ask. This is a waste of my time – a classic, shit junior doctor task if there ever was one.

      ‘They’ve specifically asked to see a consultant and won’t talk to anyone else.’ Ah. Unfair as it is, being loud, insistent and generally a pain in the arse will often get you better care in hospital. Not because we respect those kinds of antics. We just want to get you out the door.

      I walk into the cubicle, the curtain providing a thin semblance of privacy. ‘What can I do for you?’ I ask in my special chirpy but curt voice that I save for the healthy in my overcrowded, underfunded A&E department.

      ‘He’s naw well,’ the pasty woman to my left growls pointing at a child who, while bored, looks to be in rude health.

      ‘What appears to be the problem?’ I ask sitting in front of him. From his notes I can see his vitals are all normal. He doesn’t even have a temperature. He’s fine.

      ‘He keeps sleepin’ til late an’ he’s got a cough.’ The child has literally not made a sound.

      A few harmless questions later and all is revealed. He’s going through a growth spurt and tried a cheeky cigarette on the way home from school with a fellow wayward friend. Somebody call Sherlock, I have a gift.

      As I’m waving the sheepish boy and his mother out the door, I hear the ring of the trauma phone. I take the call. A two-month-old child, suspected sepsis. On the way in.

      There’s an adrenaline rush when the phone rings for an incoming trauma that even after twenty years as a doctor, I’m never immune to. After forty-five minutes of breathless work stabilising the baby, he’s being whisked upstairs to the ICU. There’s barely a moment to turn around and think before another trauma comes in. This one’s more routine. A road-traffic collision has resulted in some nasty gashes and suspected internal bleeding. That one’s off upstairs to a CT scan within twenty minutes. I’m washing my hands and trying to remember what time my son’s parents’ evening starts when one of my first-year junior doctors grabs me.

      She’s babbling about a patient crashing who had been fine and now he’s not fine and help. She’s a mess. I’ve seen it so many times before. She’s only been on the ward for ten weeks and she has a patient deteriorating and she’s panicking. I know I should be respectful and aware of the fact that she’s only a junior doctor and we all have to learn but really, it’s just annoying. I can understand a lack of knowledge and I can tolerate the mistakes made due to exhaustion. But sheer panic in an A&E department is as useful as a papier mâché boat with a trapdoor. It sounds unkind even as I think it but my immediate thought is, she’s never going to be an A&E doctor. If you can’t keep your head screwed on when a patient’s crashing then an area of medicine devoted to emergencies is not for you.

      I run with her back to the cubicle. The patient’s wife is standing next to the bed with him, crying. I practically hiss at Fiona to get him into Resus and ask as quietly, and furiously, as possible why he isn’t there already. Even a cursory look at this man and his vitals shows that he’s seriously unwell. Jesus, you don’t even need to look at him. Every machine is beeping in persistent, whining concern.

      Fiona says he’s had the flu, and he was fine when he arrived, just fine! She gave him fluids and paracetamol and had clearly hoped that he’d go away after a while, having been convinced that it was in fact, just the flu and nothing more.

      By this point the patient is dying. His breathing is laboured with the shallow pant of a body not coping with the basic requirements of taking in air. His skin has the grey pallor of someone whose bodily systems are shutting down and his temperature is climbing higher and higher. There are now seven members of staff surrounding him. Matron is taking his temperature at two-minute intervals and announcing with barely disguised disbelief that it’s climbing this quickly. We strip him and surround him with ice and cold towels. I examine his entire body looking for a wound, an insect bite, a shaving cut, a scratch. Anything that could be causing sepsis. There’s nothing. No rash so meningitis is unlikely. By this point I’m starting to think he’s past the point of no return. There’s not a huge amount you can do once the organs start shutting down. We catheterise him, give him fluids and oxygen. We pump him full of massive amounts of antibiotics and