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Izzy
It was late January and they were recording another episode featuring James for “Who We Are Now” series three. Izzy was obviously under the weather; very wheezy and had been since she got on the boat. She was moving more slowly, and honestly had barely got through the introduction for the podcast, before Alex their producer took pity and let them move onto the main event. The previous two podcasts featuring James, Izzy had been very vocal, but this time she was so reserved it was almost as if she wasn’t in the room.
She tried to surreptitiously take a puff of her inhaler. Aware of her Dad tensing next to her. He was a panicker. As much as he joked around and played it off for the podcast, when he googled asthma after her diagnosis the news that on average three people a day in the uk (out of the probably millions who had asthma) died from it, and he’d taken to carrying a back up inhaler for her on all the days he was going to see her. A move that was somehow both sweet and infantilising.
The puff didn’t help and her chest felt tighter and more painful. She realised that her breathing was becoming more audible and started to feel panicky, trying to take a full breath. She was wheezing more now. She felt her dad’s hand land warmly on her shoulder.
“What’s happening, Iz?” He asked, looking very worried. Her eyes darted to James who was looking just as concerned.
It took Izzy three tries to get her next sentence out.
“Inhaler’s not working” she gasped and took another, ineffective puff. Her dad’s arm wrapped supportively around her shoulders.
“I’m calling an ambulance.” He announced, pulling his phone out of his pocket. Izzy wanted to object but didn’t have enough breath to find the words to do so. She heard some not all of the conversation, and realised that she was probably worse off than she had wanted to acknowledge.
“Ambulance please… it’s my daughter, she’s having an asthma attack, she’s taken her inhaler five or six times and it isn’t helping… 24… she’s wheezing badly and can’t talk…”
He was then raising her hand with the inhaler in to her mouth. “Take another puff” he said to her, and she did but everything felt very far away, and it hurt, it hurt so badly. Her eyes filled with tears and she felt embarrassed to be crying at work, this was not professional!
“How long.” Her dad sounded really cross, she hoped he wasn’t cross with her, “that’s ridiculous!”
A pause then “did you say you drove today?” That was urgent, commanding, clipped, and not a way Izzy had ever heard Rich speak to Uncle James before.
“I’m parked in the underground car park, I’ll drive you to the hospital.” James was looking very perturbed and Izzy was getting the impression that something was happening she didn’t quite understand. Then her dad was kneeling in front of her, his hand gently on her cheek.
“James is going to drive us to the hospital, they’ll be able to make you feel better. Can you stand up, sweetheart?” He asked her.
She could, she was sure she could. Her dad had his arm wrapped around her and was helping her up, she was upright for maybe a couple of seconds before she felt her knees buckle, and she was weightless.
“I’ve got you, Izzy. Put your arms around my neck and hold on.” Her dad was carrying her, one arm under her knees and the other supporting her shoulders. She wrapped her arms around his shoulders and held on.
“It really hurts, Daddy.” She gasped.
“I know, we’re going to the hospital now.”
He crooned to her. “James, can you grab my bag, it has her back up inhaler in it. No,
I’ve got her, I’ve got her, just grab the door.” This second part was sharper. Then they were moving and she was losing time.
Waiting for the lift…
Being placed into the back of a car…
The car pausing in moving traffic, and her dad lifting her out as she gripped his jacket haphazardly, disoriented by the sudden shift… walking quickly into what must be a hospital from the antiseptic smell and fluorescent lighting and he was shouting:
“Please help me, she can’t breathe, my daughter, she can’t breathe!” As other hands took her from her dad’s arms and an oxygen mask placed over her face; she realised she had never heard him sound so frightened. Not even once.
Richard
He loved doing the podcast, but the episodes where James was the guest especially. There was something so comfortable about it all. He was very proud of Izzy, not only had she managed to fully come into her own on the podcast, she was also coming to work and powering through despite being under the weather. Her asthma was acting up a bit, and he would do his best to get her to take it easy for the rest of the day, but she was here now.
He continued the conversation, but he became gradually aware that Izzy was saying less and less. James was beginning to look concerned. Richard watched his daughter take a puff and automatically tensed just a little.
She would be fine, her breathing would calm down in a second. He wondered about taking a break so she could come back in with her usual energy, but James was continuing, Richard bantered something back but his eyes were on Izzy. It didn’t matter, the cameras were running but they only ever released a few short clips of video, the rest was always in audio form.
He watched Izzy take another puff of the inhaler and realised something was really wrong. She’d gone very pale and her breath was coming in little gasps. His hand automatically went to her shoulder and he tried to clamp down on his panic as he watched his daughter struggle to breathe.
“What’s happening, Iz” he asked, trying to keep his voice as calm as possible. She gasped and gasped again, trying to speak and Richard’s heart leaped into his throat.
“Inhaler’s not working” Izzy finally managed to gasp, and she brought her inhaler back to her mouth to take another puff. Richard wrapped his arm around her shoulders, both to support her and as though he could protect her from what was happening. His right hand reached for his phone as he announced that he was calling an ambulance. The producers listening in would have stopped the recording by now, and indeed the door was opening.
His hands were shaking so badly it took him two attempts to open the keypad on his phone. Once opened he dialed 999 and waited what felt like an age for someone to pick up and put him through for an ambulance. He gave the details of the situation as calmly as he was able. Listened to them tell him Izzy needed to take another puff once a minute for the next four minutes, then wait ten minutes, and if she wasn’t better then repeat for ten puffs.
Then they told him the wait for an ambulance was two hours. An overstretched service. She wasn’t in immediate danger as long as she was breathing a little.
“That’s ridiculous! She’s white as a ghost, she can’t breathe, we need an ambulance as quickly as possible!” Richard practically shouted down the phone.
“If you can get her to the hospital yourself sooner than that it would be a good idea.” The call handler said, not letting Richard’s anger and fear ruffle them in the slightest. Richard always got public transport to the podcast studio, occasionally took a car if he was driving straight back to Herefordshire afterwards but not usually. How was he going to get Izzy to the hospital. Most taxi’s would drive off rather than take someone so obviously unwell. He tightened his arm around his daughter and tried to think.
Then he remembered: James was driving straight on to his country cottage afterwards. He has asked Richard to organise a parking pass for him last week so he could park in the tiny underground car park here at the studio. He looked at one of his oldest friends, who was looking very alarmed at the whole situation, and explained as quickly as he could.
“If we wait for an ambulance it’s two hours. Did you say you drove today?”
James caught on immediately with an offer to drive them to the hospital and Richard turned his full attention back to Izzy who was wheezing more shallowly now and had gone even paler. He knelt in front of her, to try and keep her focus on him.
“James is going to drive us to the hospital, they’ll be able to make you feel better. Can you stand up, sweetheart?” He asked, feigning a calmness he didn’t feel even a little bit. Izzy nodded and Richard jumped to help lift her to her feet; an arm supporting her under her shoulders.
Once standing, she swayed uneasily and then her knees gave out completely. Swearing, Richard kept his right arm firmly around Izzy’s shoulders and ducked to slide his left arm under her knees as he lifted her. She wasn’t his little girl anymore, she was an adult and an astonishingly capable and talented one. He honestly never thought there would be a time when he carried her ever again but he was so very glad he was still able to. Her breath came out in uneven distressed gasps.
“I’ve got you, Izzy.” Richard was aiming for comforting with his tone of voice but he was so terrified and so desperate to get her to a hospital he wasn’t sure he could hit it. “Put your arms around my neck and hold on.” She did so and he was ready to move. He didn’t want to risk delaying Izzy’s treatment by even a second.
“James, can you grab my bag, it has her back up inhaler in it.” James was already doing that and one of the producer’s came to try and take Izzy from him. Richard panicked for a moment “No,” He shouted twisting away from the reaching arms. “I’ve got her! I’ve got her!” The producer stepped back and Richard walked hurriedly through the held-open doors, James at his side. Richard was probably being irrational, a man in his 20s or 30s could probably carry Izzy more easily than he could with his dodgy knee, but he couldn’t bear to let her go.
They didn’t get very far before they had to wait for the lift, but luckily, James was parked in the tiny basement car park, and soon enough he was jogging a little ahead and opening the back passenger side door. Richard wasted no time in placing Izzy in the car, and pressing her inhaler to her mouth again. She was barely conscious. He did her seatbelt up, and then rushed around to the other back seat. He didn’t know if he’d be able to do anything if she stopped breathing completely on the way, but he had to be close enough to try. Richard blinked a few tears out of his eyes as James moved out of the car park and into the London traffic as swiftly as possible.
James knew better than to give false reassurances. “We’ll be at A&E in five minutes, Hammond.”
Those five minutes stretched out like an eternity to Richard, he urged Izzy to take her final allowed gasp of the inhaler, for all the good it was doing. It seemed to make no difference at all.
“It’s just around this next corner, I’m going to put the hazards on so you can get her out and seen as quickly as possible. When I’ve found a place to park I’ll come in and find you.” James said calmly.
Richard’s head jerked up, alarmed. “What about your weekend away with Sarah?” He asked.
“I’ll come in and find you, I’m worried about Izzy too, and you’re many things but not the most level-headed in a crisis.” James explained. “I’m pulling in now.”
James switched his hazards on and pulled as far out of the main road as possible, to a few objecting beeps behind him. Richard jumped out of the car, slamming the door behind him and ran around to open Izzy’s door. Her eyes were closed, and her lips were blue but she was still gasping for breath.
Richard undid her seatbelt and squatted down, gently leaning her forward as he curled one arm around her back then slid the other one under her knees. He stood, staggering back a few steps as he did so, adjusting to the Izzy’s weight in his arms and desperate not to whack her head on the top of the car. He kicked the door closed and walked as swiftly as he was able into the Accident and Emergency department, shouting as he did so.
“Please help me, she can’t breathe, my daughter, she can’t breathe!” A couple of nurses and a doctor rushed over straight away with a gurney, and even in his terror, Richard was mildly astonished that they could be available so quickly. Izzy was laid down and her breathing was shallower and shallower.
“How long has she been like this?” The doctor asked, as she peeled back Izzy’s eyelids to check her pupils with a small torch.
“It started about 20 minutes ago, she only lost consciousness in the car and the drive was only 5 minutes. She has asthma, I’ve been giving her her inhaler but it isn’t making any difference.”
The doctor was now listening to Izzy’s upper back. “Pleural effusion. We’re going to the corridor next to exam room three.” And they were walking quickly with the gurney. Richard hurrying along besides.
“Will she be okay?” He asked.
“We’re doing everything we can.” The doctor replied.
Richard’s heart dropped into his stomach, he needed to call Mindy, to tell her what was going on. Everything had happened so fast. Izzy had been completely fine less than an hour ago. Well maybe not completely, she was feeling a bit wheezy, but she often was these days. He blinked a few tears away and clung to Izzy’s hand.
“You’ll be okay, just wake up, please come back.” He said quietly, wanting her to hear despite her state of consciousness, but not wanting to distract the doctors.
Then the doctor was pulling Izzy’s t-shirt and jumper up to expose her rib cage and putting an absolutely enormous needle into her side. She pulled the plunger and a yellow fluid came out. Izzy breathed into the oxygen mask slightly more deeply. The doctor repeated this three more times until the final time only half a tube full emerged. To Richard’s immense relief, Izzy seemed to be coming round, and breathing much more easily.
The doctor turned her attention to speaking to Izzy, while one of the nurses dressed the puncture wound in her side.
“Can you keep your eyes open for me?” The doctor asked. Izzy looked confused and a little hostile. Richard made sure he was in her field of vision.
“You’re in hospital, Iz. You were struggling to breathe so we got you here as quickly as possible.” Izzy looked slightly less alarmed upon hearing this and the hostility gave way to fear. The doctor carried on:
“You’re wearing an oxygen mask, and you couldn’t breathe not because of your asthma, but because you had fluid build up in your left lung that made it difficult. It’s called a pleural effusion, we drained it, which is why you can breathe more easily now, but I need you to keep wearing that oxygen mask. You can lift it away from your face briefly to answer questions, but you want to keep it on in between. Could you rank your pain between one and ten?” The doctor asked.
Izzy lifted the mask a little with a trembling hand. “6” she replied. The doctor kept running through an exam, to check cognitive function and finally moved on to what happens next.
“Okay, Izzy. You’re stable at the moment, but pleural effusions don’t happen at random, and they aren’t usually caused by asthma so we need to run some additional tests, to make sure it doesn’t happen again. Unfortunately, we need the bed, so my colleague, John, here,” -at that she nodded at one of the nurses, the tall one who had placed Izzy down on the gurney in the first place. “Is going to get you a wheelchair. We’ll attach the oxygen canister to, it. When it’s getting low it will start beeping and if you could alert a nurse at that point, Mr Hammond” Richard jumped at being addressed, “But in the meantime we’re going to send you out to wait in A&E.”
Part of Richard wanted to fume, he felt impatient and powerless. Couldn’t they just run the tests now? But he knew how lucky he was that there had been a staff member available to help Izzy at that exact moment. They had saved her life most likely. None of the three had said that but the speed in which they reacted to her crisis, and the immediate treatment and oxygen mask implied it. Now they would have to wait their turn. And he needed to phone Mindy. He’d get Izzy settled first though, maybe get James to sit with her while he made contact.
A wheelchair was brought, and it was only when Richard pushed Izzy back into the main waiting room, thankfully finding a seat with a space for the wheelchair next to it, when he realised he had left his bag in James’s car. At that moment, James walked in, Richard’s bag over his shoulder and was looking around the room for them. Richard waved subtly to help James spot him, and his friend made his way over.
“You’re already looking a lot better, Izzy,” James looked mildly baffled at how quickly she’d regained most of her colour, and she even seemed like she was breathing normally again, but for the oxygen mask.
“I had a pleural effusion.” Izzy sounded hoarse as she held the mask away from her mouth. “They took a load of gunk out of my lungs so I can breathe again, but we need to stay here and wait our turn so they can do some tests to work out why it happened.”
James looked shocked, but was very relieved to see his honorary niece looking so much better regardless.
“Izzy, I need to let Mindy know what’s going on, so I’m going to go outside to make a phone call, James, do you mind sitting with Iz for five minutes while I do it.”
James nodded but Izzy looked cross; she yanked the oxygen mask away from her mouth: “I don’t need a babysitter, I’m an adult!” Richard felt the emotion bubble up inside him, but he forced it down.
“Izzy, I’ve spent most of the last half an hour watching you struggle to breathe so badly you lost consciousness. I know you’re an adult, but you’re still my little girl, and I’m terrified of losing you. Please indulge me this, while I loop Mindy in. She’ll be keen to hear from you too, but it would make me feel better if James sat with you while I can’t.”
Izzy mumbled an apology, she was out of sorts but hadn’t processed what happened enough to be scared herself. And her chest hurt, she could breathe okay but the sharp stabbing from the treatment had given way to a dull, persistent and very uncomfortable ache.”
Richard kissed the top of her head. “I love you.” He said quietly, before leaving the room to make his phone call. He needed to step outside the hospital completely. Internet didn’t have the best service in Herefordshire, and while whatsapp messages would probably work, they wouldn’t have the urgency that was needed. He took a couple of puffs of his vape to steady himself before dialling Mindy.
“Minds, something’s happened, Izzy’s okay for the moment, but she’s not well and we’re at A&E”