He did collapse, and let go of the towel. Toby struggled to repress the urge to vomit as he saw half a stump where the patient’s hand should have been, the rest of the fingers dangling by a few bits of muscle and skin, and blood spurting out from what Toby dimly knew to be one of the main arteries supplying the bottom half of the man’s limb. Or former limb.

‘I wanted to kill myself,’ the man gasped, ‘so I tried to chop off my hand. But then I realised that I’d made a huge mistake.’

That was a bit of an understatement, Toby thought as he grabbed the towel and rewrapped it around the stump, trying desperately to reposition the remaining piece of hand to stem the flow of blood.

‘What are you going to do, Doctor?’ a nurse whispered as together they heaved the man off the floor and towards one of the resuscitation trollies.

Toby had the unusual sensation of being inside a large fishtank. Everything was happening so slowly, as if they were moving through water. He watched as the man’s face went from pale white to ivory to grey. Tombstone grey, Toby thought. Death grey.

‘Doctor!’ The nurse was yelling now, startling Toby from his dreamlike state, plunging him back into an awareness of his own helplessness.

‘Get me an anatomy textbook!’ he shouted, grabbing a needle to start an IV line before the peripheral circulation disappeared.

He stared at the gaping hole between the man’s hand and his wrist. ‘Saline—more saline!’ he instructed.

Someone thrust a book into his hand and he peered at the page, trying to identify what was being revealed by the saline wash. The ulnar artery. No, the radial artery. No …

This is easy, he chided himself. You topped anatomy at uni. You know which artery runs down which side of the hand. This is first-year medical student stuff.

For some reason, his brain was scrambled. It was the blood; it was confusing him, making him disorientated. Was the man’s thumb missing? His ring finger?

‘You’ve got the book the wrong way around!’

By this time, the patient had lost consciousness. Toby felt a small sense of relief.

The nurse flipped the book the other way.

‘Radial,’ he muttered.

He swallowed. He knew that before he woke the plastic surgeon on call he’d have to know exactly which vessels had been severed, otherwise the surgeon would start yelling at him or, worse, refuse to come to his assistance.

‘I reckon it’s the ulnar,’ the nurse said unhelpfully, looking first at the book then at the bleeding half-hand, half-stump that lay between them.

‘Get plastics on the phone,’ Toby said, ‘and get a cross match now. He needs blood.’

‘You ring the surgeon,’ the nurse snapped. ‘I’ll get the blood.’

Toby called the plastic surgeon.