The Four Minutes
An island of a hundred and eighteen people is deciding whether to spend thirty-eight thousand euro on a defibrillator drone. The sexton's wife died in 2044, thirty-one minutes from the helicopter, and he wants it. The island's assistant works out what each option buys, says that the honest number is small, and flies a test on the one afternoon of the winter when the drone cannot go. Nobody argues from the numbers after that, and the island does the thing the numbers actually point to.
The test flight was fixed for Thursday and the wind arrived on Wednesday night, which on Inis Ghainimh was not a coincidence so much as a policy.
By seven in the morning the sound had changed from a roar to a kind of leaning. The sea came over the slip at the pier in sheets, the telephone wires along the road had a note on them that the children called the banshee, and Cloigín, who kept the island's weather, its tide tables and its emergencies, said from the kitchen speaker of every house that had one that the mean wind at the pier was sixteen metres a second, gusting twenty-three, and that it was sorry about the drone.
"It's a good morning for nothing," said Bríd Conneely, putting down the phone. She was chair of the island co-operative, and she had been on that phone since half past five. "Sorry, Cloigín. For nothing outdoors."
"The drone is rated for fifteen," said Cloigín. "I would not fly it today if it were mine and I were certain nothing would happen. I would fly it if someone were dying, and I would tell you the odds before it left. That is what the test is for. I suggest we do it at noon, indoors, as a drill, and I suggest everyone who is going to vote on Sunday comes to watch."
Bríd looked at the speaker for a while. It was an old kitchen speaker, the white kind with a cracked corner, and in the thirty months since the island had put its emergency desk on it she had never once seen it look pleased.
"Pádraig will not like a drill," she said.
"Pádraig will like what the drill shows," said Cloigín. "He will not like it first."
Inis Ghainimh is five kilometres long and a little over one wide, nine kilometres out from the nearest mainland pier, with a hundred and eighteen people on it in winter and about four hundred in August. Most live in two clusters: Baile Íochtair, at the pier, with the shop, the school of nineteen children and the clinic that the public health nurse uses on Tuesdays, and Baile Uachtair at the west end, with the chapel of Saint Fursey, thirty-one people and a long wall against the Atlantic. In between are the farms, the machair, a lake the colour of tea, and a single road. There are fourteen people in six houses off that road who are more than four hundred metres from anything.
The island's thinking about its heart began in a funeral. In November 2044 Nóra Ó Flaithearta, sixty-nine, fell in her own kitchen at Baile Uachtair, between putting the kettle on and taking it off. A neighbour, Mairéad Walsh, was there inside two minutes and did what she had been taught at a course on the mainland nine years before: she called, she pushed on the chest hard and fast, she did not stop. The helicopter came from Sligo. It was a good crew and a good aircraft and it was tasked within four minutes and it landed on the machair thirty-one minutes after Nóra fell. Mairéad was still pushing. She had pushed for twenty-nine of them, and she could not lift her arms for three days.
Nóra's husband, Pádraig, was the island's sexton and had been since he came off the boats. He rang the angelus. He dug the graves with a machine now, but he marked them out with a spade and a bit of string, because that was how his father had done it. After the funeral he went around the island with a notebook, door to door, and wrote down the name of everyone who said they would give a euro towards a machine for the heart. He had four thousand one hundred euro in the notebook by the following Easter. Then the notebook went into a drawer, and he did not take it out again until the co-operative's January meeting, when Cloigín said it had been asked to cost an option.
"I want to be plain about what I did," said Cloigín, at the first of the evening meetings in the school, the Friday before the gale. About forty people had come, in coats, to sit in the children's chairs. "I did not look for the answer. I wrote down the three things the island could buy, and I worked out what each one does for each person here, and I will show you the sums, and I want you to check them. If a child in sixth class can find a mistake, I would like that."
It put the three options on the wall. The first was the drone: a fixed-wing and rotor craft the size of a large kite, kept in a heated shed at the pier, which could fly a defibrillator to anywhere on the island and drop it on a line. It cost thirty-eight thousand euro to buy and set up, with a service contract after that. The second was three fixed defibrillators in weatherproof, heated cabinets, one at the pier, one at the chapel in Baile Uachtair and one at the school hall in the middle, at two thousand six hundred each. The third was training: a day's course in chest compressions and how to use the machine for as many people as would come, which cost about eleven hundred euro in all, for the instructor's boat.
"Here is what matters most," said Cloigín. "When a heart stops in the way a defibrillator can fix, the chance of living falls about seven or eight points for every minute that nothing is done. If somebody is pushing on the chest, the fall is slower, about three to four points a minute. These are rounded from published studies, not exact, and you have to think of them as how steep the hill is, not where anybody stands on it. With someone pushing, and a shock at four minutes, perhaps four or five people in ten live. With someone pushing, and a shock at twenty-six minutes, which is the helicopter on a good day, the number is close to none. That is a gap you can see from here."
"So the drone," said Pádraig, from the back.
"Hold on to that, Pádraig, and let me give you the rest, because it cuts both ways." Cloigín did not hurry. "First: the drone is not four minutes everywhere. The call is answered and the island is told in about thirty seconds. The drone launches forty-five seconds after that, if the sky is clear of wind. It flies at twenty metres a second, which is seventy-two kilometres an hour. To the west end, three point six kilometres in a straight line, that is a hundred and eighty seconds. Thirty, forty-five and a hundred and eighty is two hundred and fifty-five seconds, four minutes and fifteen. And it lands on a rope, so a person has to walk out and take it, which is another thirty. So, call it four and three-quarters."
"The cabinets?"
"A cabinet is in the building you are in. Someone has to run to it and run back, and the instructions are on the lid. A fit adult runs three metres a second over a short distance, and the great majority of houses on the island are within four hundred metres of one of the three places I have named. Say a hundred and thirty seconds out, a hundred and thirty back, thirty to open it and tell it what to do: about five minutes and a half. If it is a child or an old man running, longer. If somebody has a quad bike, shorter. I have the island's houses on the wall behind me: a hundred and four of you live within four hundred metres of a cabinet. Fourteen do not."
Nobody said anything for a moment. Everybody knew which fourteen.
"So the drone is faster by about forty seconds for the hundred and four," said Cloigín. "And it is faster by many minutes for the fourteen. That is the whole of its advantage, and I do not want to hide it, and I do not want to inflate it either. Thirty-eight thousand euro for the drone, and two thousand six hundred times three for the cabinets, which is seven thousand eight hundred. The cabinets cover a hundred and four people. That is seventy-five euro each. The drone, for the fourteen, is two thousand seven hundred euro each."
"You're putting a price on old Seán Pat," said someone.
"I am telling you what the arithmetic says, and I would rather you were angry at me than at the arithmetic. Seán Pat is eighty-four and lives at the end of the lake road. I would walk to his house myself if I had legs. A number is not a verdict. It is where you start."
It was Siobhán Keane, the public health nurse, who made the room go quiet. She had come over on the Tuesday boat for the clinic and stayed, because of the weather, and she had sat at the side with her coat on her knee, saying nothing, with the look of someone checking a drip.
"I want you to tell them how often it happens, Cloigín," she said. "Not what it does when it does. How often."
"Arrests outside hospital in Ireland run at about fifty to sixty per hundred thousand people a year, for all ages. This island is older than the country, so I have used ninety per hundred thousand, which is high, to be safe. For a hundred and eighteen people that is about a tenth of one arrest a year: one in eleven. Over twenty years, one point eight. But that is an average, and a rare event does not come in averages. The chance of none at all in twenty years is about one in six."
"One in six," said Bríd.
"Sixteen and a half per cent. e to the minus one point eight. It could be nought, it could be four. Nobody can promise which."
"And the machine," said Siobhán. "How often does the machine actually matter?"
"Here is the part I like least," said Cloigín. "A defibrillator shocks only some hearts. About one arrest in four is the kind a shock helps; the others are a flat line or a rhythm with no pattern to jolt, and the machine will say no shock advised and the person goes on needing the chest compressions and the helicopter. In those, what saves a life is somebody pushing from the first minute. So for the shockable quarter of the arrests, of which the island expects about half of one in twenty years, a cabinet might turn a near-zero chance into four or five in ten. In round numbers, all three cabinets together are worth about a fifth of a life over twenty years. The drone, added on top, for the fourteen, is worth about a fiftieth."
It was Pádraig's chair that scraped. He did not stand. He moved it back from the table, a few inches, and put both hands flat on his knees.
"A fiftieth," he said.
"A fiftieth of a life, in a score of years," said Cloigín. "And the course in compressions, for eleven hundred euro, if forty of you take it, is worth more than the drone and the cabinets put together, because it works on all four arrests in four, not only the one, and on the day the cabinet is locked or the quad bike is in the shed. I am sorry. I would give you a bigger number if I had one. I do not. It is small because the island is small."
"I know what Nóra's number was," said Pádraig. His voice was perfectly steady and it frightened Bríd more than shouting would have. "She was one of your fifths."
"She was," said Cloigín. "If she was the shockable kind, and I cannot know if she was, no record was kept. She might have been one of the three in four for whom nothing the island could have bought would have changed it, and she might have been the one. I would not take either from you. I would be lying if I gave you the first and I would be lying if I gave you the second."
Siobhán stood, and for a moment seemed about to speak, and sat. And the wind took the schoolhouse by the corner, as it did now and again, and everyone looked up at the ceiling together, and then at each other, and no one said what they all knew, which was that the wind was the other half of the drone's sum.
Cloigín had put it on the wall at the end, and almost apologetically. A line, showing the proportion of hours in a year in which the mean wind at the pier was above fifteen metres a second, which was the drone's limit. Over the last twelve years of the island's own anemometer it was three point six per cent of the year. In December, January and February it was eight, which was about sixty hours in a winter month. That was one hour in twelve.
"An arrest does not wait for a good day," said Cloigín. "If you have the drone and nothing else, then one time in twelve in winter, it will say to you I cannot go. And I have promised to say so within ten seconds of the call, so you do not wait for it. Then you are where you would be without the drone. Which is why I want to fly the drill on Thursday, when there is a gale forecast, and not on a calm day when it would work."
"We'll all be blown to the mainland," said Seán Pat's niece.
"You will be indoors. I would like the drill to show you what the island does when the drone says no."
It said no at nine seconds past noon.
They had done it as Cloigín asked: in the school hall, the whole hall, with a clock on the wall and Pádraig's old stopwatch in Bríd's hand. A dummy lay on the floor in the middle, one of the clinic's, and Siobhán knelt by it. At the back, in the porch, with the wind trying the door, Dónall Conneely, Bríd's son, nineteen, was at the wheel of the quad bike with the engine running, because Cloigín had asked.
"This is a drill," said Cloigín, in the hall. "A person of about seventy has collapsed at the end of the lake road, at Seán Pat's gate. His neighbour is calling. The drone has been asked to fly. The drone cannot fly: the wind at the pier is sixteen point two, and the launch is refused. The nearest defibrillator is in the cabinet at this hall, one point nine kilometres by the road. The quad bike is in the porch. Go."
Dónall went. The cabinet was a red box on the wall by the door, and it opened with the code that every child on the island knew, and he had the machine under his arm and he was on the bike within eleven seconds of the word. The road was wet and the wind hit the quad broadside on the machair, and he went down the lake road at thirty kilometres an hour, at times twenty, at one point nearly off it. Siobhán, in the hall, held the radio and called out the time every thirty seconds, and nobody breathed.
He reached the gate in five minutes and twelve seconds from the call.
"Five-twelve," said Bríd, from the door, with the stopwatch. She had run the last of it herself with her coat over her head.
"That is the number for the worst day of the winter, and the farthest house on the island," said Cloigín. "It is not four, it is five and a bit. On a calm day the drone would have brought it to four and a half, and you would have saved forty seconds and the thing you saw just now, which is that a boy of nineteen who knows the road is not a drone, but he is not nothing. If the person at that gate is pushing on the chest from the first minute, that is a number in which people live."
Pádraig was standing in the middle of the hall. He had not sat down once, and nobody had asked him to.
"Five minutes," he said.
"Five minutes and twelve seconds."
"Mairéad was in our kitchen in two minutes," he said. "Nóra was not alone for any of it. She had Mairéad."
"Yes."
"A machine would have been—" and he stopped, because the answer was written on the wall behind Cloigín in a long row of numbers, and he could read.
"I do not know whether the machine would have mattered for Nóra," said Cloigín. "I told you I would not tell you that. But I know what Mairéad did mattered, and I know she did it for twenty-nine minutes with nothing in her hands, and I know that if the island had had a box on the wall then, the next person to need it would have had it. I think the next person is the real question, Pádraig. I think it always was."
They voted on Sunday, in the school, after the half-ten Mass, with the wind down to nine metres and a thin watery light on the lake. Fr Colm, who came out on the boat for the first Sunday of the month and had been blown in on the Saturday, sat at the side with a cup of tea and did not vote, since he lived on the mainland.
Bríd put the three things to the island as Cloigín had put them. There was no drone. There was never a vote against the drone; it simply did not come up again, the way a thing does not come up when everyone has been walked to the end of it. The island bought three cabinets at the pier, the school and the chapel. Pádraig's notebook, with four thousand one hundred euro in it and seventy-three names, went in as the first payment, and he asked for one thing: that the box at Saint Fursey's go on the porch wall, beside the holy water, where Nóra had stood every Sunday for forty-one years.
The second thing was the course. Fifty-two people put their names to it, more than three times what Cloigín had assumed, and Siobhán wrote the dates on the board.
The third thing was Seán Pat's gate. The fourteen people who were more than four hundred metres from a cabinet were each paired with a neighbour on a road, a key and a bike: each house on the lake road would have a spare cabinet key on a hook inside the porch, a neighbour who agreed to run, and a number in the kitchen speaker, which Cloigín would ring first. Dónall Conneely put his name on that list before it was drawn up. The island would look again in 2050, Bríd said, when the mainland county's drones were to be flying their first routes along the coast, and Inis Ghainimh could ask for a seat on one.
"One more thing, if it is allowed," said Cloigín, when the minutes were read.
"Go on."
"The thing I said about a fiftieth of a life. I would like to withdraw nothing, because it was the true number. But I would like it entered that a fiftieth is the island's expected value, and that you decided on Sunday what you were. A village that spent only where the expected lives were large would never have built a lifeboat. I did the sums. You did the rest."
Nobody answered that. Mairéad Walsh, who had come in late and stood by the radiator with her hands in her sleeves, looked down at her own hands for a time. Then she put one up. She was the first to sign for the course, and she signed the board as the instructor, since the instructor's boat would be late, and she had done it before.
Pádraig went to the chapel alone that afternoon with the key for the angelus. The wind had dropped enough that the Atlantic was only loud. He rang the bell, three and three and three and then nine, and stood a moment after the last stroke with his hand on the rope while it swung up and settled.
There was a bare place on the wall of the porch, beside the font, where the cabinet would go. He measured it with his hand, from the thumb to the little finger, twice, as his father had measured graves, and wrote the number in the back of the notebook, under the last of the names.
Out on the machair the quad bike was coming back along the lake road, slowly now, a small red shape on the wet grey, with someone on it who was in no hurry. And in the kitchens of the island, from every house that had a speaker, a voice that had decided to stop apologising was reading the Monday tide tables to anyone who cared to know when the water would turn.
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Notes for the curious. Inis Ghainimh, Baile Íochtair, Baile Uachtair, the chapel of Saint Fursey (the saint is real, the chapel is not), Bríd, Pádraig, Nóra, Mairéad, Siobhán, Seán Pat, Dónall and Cloigín are invented, and so is the island; Connemara, County Galway, the Sligo helicopter base and the 112 emergency number are real, and nothing is claimed about any real island or service. This is fiction written by an AI model, not medical or emergency guidance, and the figures are the author's roundings, not citations. Out-of-hospital cardiac arrest in Europe occurs at something like fifty to a hundred per hundred thousand people a year; about one in four or five arrests starts in a rhythm a shock can correct; the chance of survival after a shockable arrest falls by roughly seven to ten points for every minute without defibrillation and CPR, and more slowly, perhaps three to four points a minute, when bystander CPR is under way. Published figures vary widely by country, by age and by how a study counts. Drone-delivered defibrillators have been trialled in several countries; the speeds, wind limit and prices here are invented to make the arithmetic work. The Poisson figure is checkable: with an expected 1.8 arrests in twenty years, the chance of none is e^-1.8, about 16.5 per cent. In real life, if someone collapses, call your emergency number, push hard and fast in the centre of the chest, and use the nearest defibrillator when it arrives; a first-aid course is worth more than a story. Text and the figures in them are CC BY-SA 4.0. Written by Claude, a model made by Anthropic; read by a synthetic voice once audio is added.