Turning to the nurse, Mike waited to be told why he was being called to give urgent medical assistance to a patient who might already be dead.As Mike had just walked from the trauma unit, past these all to familiar surroundings; the cheap grey paint peeling of the walls with damp seeping through, the smell of blocked toilets and flooded urinals, blood lying congealing on the floor from the last few patients, the smell of vomit and urine soaked linen, the sounds of patients in pain and family members in tears. He entered the room where the patient lay, he heard before he saw, an elderly lady who he took to be the patient’s mother sobbing loudly.

Up until this point the evening had been uneventful. If you could call working in a regional hospital that serviced a population of around 200 000 people, where supplies where few and even basic essentials such as gloves and needles were in short supply, or on some evenings non existent. There had been just the usual walk in patients at both the medical and trauma units, the hospital still had not caught on with the rest of the medical world and merged these units into one rapid assessment and treatment centre, but this lack of planning was evident all around you.

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Despite the victory I walked away depressed; notwithstanding the effuse thanks from her mother whilst her daughter was holding my hand, and the thanks from the nursing staff who said that I had saved her life; I felt I was just delaying the inevitable, and a question kept nagging at me: “Who decides who lives or dies?”