‘Can I help you?’

Daft question as this is A&E. The man looks old and frail. Fear in his sunken eyes. I ask what’s wrong. He gathers breath and wheezes out, ‘Chest pains.’

I take down his details and notify the triage nurse. He shuffles slowly across the room and slumps in a chair in the crowded waiting area, head-down, as if expecting the executioner’s axe. I get him some water from the cooler. My dad died of a heart attack so I feel for him. His name is Larry. Mine’s Doreen. I try to reassure him above the din of screaming toddlers, the TV, shrill phones, groans from the unisex toilet, beeping monitors and the hurried patter of footsteps down corridors. It’s early January and cold. Christmas gone and the New Year already heavy with weariness and dread.

Kingston, Jamaica, was never cold, but we were poor, so I came here for a better life. Couldn’t get into nurse-training so ended up working on Reception in the city hospital’s A&E unit. I also do some evening cleaning to help my sick mother in Kingston who has trouble making ends meet since Dad died. I go to church most Sundays. In my spare time, I go to the pictures with my friend Doris, or visit the nearby park to feed the ducks and walk among the shrubs and flower beds. One time, after we’d seen a Julia Roberts film called Pretty Woman (I’m not pretty, by the way), I gave a young street beggar five pounds. Doris said he would spend it on drugs and had a go at me for being stupid. Two weeks later he turned up in A&E and punched me in the face when I couldn’t prescribe him methadone. That’s life, I guess.

It’s late Friday night. Sirens wail across the city. Ambulances pull up every few minutes and in they come: on trolleys, in wheelchairs; old people with blank stares and gaping mouths; truculent drunks on splayed legs; frantic mothers cradling toddlers – the everyday flotsam of shipwrecked lives. Behind me, nurses and doctors in front-line wards battle to contain the rising weekend tide. Curtained cubicles full of anxious faces waiting on X-rays and blood test results, pining for the mislaid lives they once took for granted. Every minute, every hour, twenty-four hours a day, every day they come. It all seems so futile. Is it worth it, all this – the cost, the effort, the stress, the squandered lives damaged beyond repair? Then I remember my dad and feel ashamed.

The man with chest pains walks past me on his way out. He is now jaunty and smiling broadly. Obviously good news. He says goodbye and I wish him well.

Three days later, my supervisor hands me an envelope. Inside is a slip of paper with the words:

Dear Doreen,

Thanks for being so kind. Hope your mother is OK.
All the best

Larry

Two return air tickets to Montego Bay are enclosed.