Hospital Circles

by Lucilla Andrews

  Sister Marcus said Mr Francis was rather poorly and had been moved from the Seriously Ill to the Dangerously Ill List. The General was with him. ‘I expect he will stay a little longer,’ continued Sister. ‘His son likes having him there.’

  It was a Benedict’s rule that the close relatives of a D.I.L. must be allowed unrestricted access to their ill relative. Some people took full advantage of this; quite as many others did not. ‘I mean, it’s not as if there’s anything I can do, is there, Nurse? He is in the best place, and I’m sure I’d only be in your way. You’ll let me know if anything ‒ well ‒ happens ‒ won’t you?’

  That had shocked me until I heard it too often to remain shocked. It still left me feeling sickened by the whole human race, until some devoted parent, husband, wife, or adult child of an elderly parent put things right for me by spending days and nights at a bedside.

  There was nothing General Francis could do, and because of his arthritis he could only sit with any comfort on a hard chair. He sat still and straight-backed, where his son could see him and exchange an occasional word or smile, but well out of my way. He did not move until Bill slid into a heavy sleep after midnight.

  The S.S.O. arrived as he was leaving. Old Red watched the older man’s slow movements clinically as he held aside the red screen, then followed him out to talk. I thought the S.S.O. seemed puzzled, but as the light was dim I could have been mistaken.

  On his return he puzzled me by behaving exactly as I expected an S.S.O. to behave. If he remembered our meeting in the subway or my relationship to my aunt, very correctly, he gave no sign. He ignored me until forced to ask a professional query, and then asked it of my cap. Having received identical treatment from rows of Benedict’s men on duty, I could not conceive why Old Red should be the object of so much wrath from my fellow nurses. Certainly his terse telephone technique had annoyed me last night, but not enough to make me want to spit at the sight of him. What was there about him? I wondered, watching him brood over the row of charts. At face value he was quite a man. He lacked General Francis’s extreme, if ageing, good looks and enchanting manners, but take him out of his white coat and he’d be dead sexy. That, of course, was the answer. The girls would forgive fat little Dr Curtis, the S.M.O., with his thinning hair and glasses, for ignoring them, as who wanted to be noticed by Chubby Curtis? Also Chubby Curtis had a wife. Old Red was another matter.

  Dr Curtis came in with Humber a few minutes later. The two senior residents frowned in unison at the rising temperature chart. ‘He’s a good age and build,’ said Dr Curtis. ‘Let us thank God for youth when the antibiotics fail us. How’s the leg shaping, Red?’

  ‘Fine. He’ll be in a walking plaster in a few days. I think I’m right in saying the plaster theatre’s booked for him on Tuesday afternoon next week.’ He glanced briefly at Humber. ‘Will you tell Sister Marcus?’

  ‘Yes, Mr Leland.’ She caught my eye expressively as Dr Curtis voiced our thoughts.

  ‘Bit of an optimist, aren’t you, Red?’

  The S.S.O. was now watching the rise and fall of the little green rubber bag attached to the oxygen mask. ‘I don’t think so.’

  Humber returned momentarily after the men had gone. ‘Old Red stuck his neck out all right. Hope to God he’s right.’

  ‘Yes,’ I said, ‘yes.’

  She looked hard at me, and then at Bill Francis. He was so far under as to be very near coma. ‘Seeing ’em like that always ties my inside in knots, too. Oh, well, this won’t soothe any fevered brows. I must get back to my poor mangled sods. I’m very much afraid one can’t last the night, and I’ve ugly doubts about another. Ring if you want me.’

  No-one died in Marcus that night. In the morning Humber, Gwenellen, and the night junior looked exhausted and triumphant. I was glad for them, but I only felt exhausted. Bill Francis had woken at dawn. He had been perfectly coherent and much too bright. He had insisted I call him Bill. ‘The day nurse does, so why not you? You’ll have to get used to it when we’re married. You do know you’re going to marry me?’

  ‘Frankly, no, as the question has not yet arisen.’

  ‘You mean I haven’t asked you? My dear sweet angel, Nurse Dungarvan, I’m not that much of a mug! If I asked you now wouldn’t you have to say “no”? Hospital ethics and so forth?’

  I did not take any of that seriously, though I would have had to be ice all through to hear it with utter indifference. I was slowly coming to realize that I was not at all indifferent to my patient. That was one reason why I was so exhausted that morning. He was a patient. Every Benedict’s nurse was warned of the consequences to herself if she were fool enough to let herself get emotionally involved with a male patient, before she left the P.T.S. Briefly, it was the quickest way out.

  Sister Marcus had looked perturbed by my night report. That was her half-day. She was still on duty when we went on that night. A coach filled with holidaymakers returning from a day-trip to the sea had hit a double-decker bus on a new clearway two miles from Benedict’s. There were four emergency beds up in the centre of the ward. One of the coach passengers died just as we arrived on duty. Sister Marcus gave us the report with her sleeves rolled up. I had never before seen any Benedict’s sister do that. But until last Saturday night I had never seen how a major accident ward looked directly after a major accident.

  ‘Mr Francis,’ began Sister Marcus, ‘is poorly.’

  General Francis spent all that night on his hard chair on the other side of the bed. Corporal Wix stayed as well. The duty room was lined with armchairs borrowed from other wards for the relatives of the crash victims. Humber offered the Corporal one of the armchairs. He barely used it. He removed his jacket, rolled up his sleeves, buttoned his tie inside his shirt, and, according to Gwenellen, took over Marcus ward kitchen. He made countless pots of tea, set and washed up tray after tray, helped the night junior hand round tea to the stunned, grey-faced rows of waiting relatives.

  I told General Francis this in one of the quiet intervals when he and I were alone with his sleeping son. ‘The night staff are so grateful. They say he’s as good as an extra night nurse.’

  ‘Wix is a good man. He’ll be happier if he can make himself useful.’ Another theatre-trolley returning rumbled by on the far side of the red screen. ‘Do you have many nights like this?’

  I explained my not being a Marcus regular nurse. ‘I gather this is bad for a mid-week night, but typical of any summer week-end. Bank Holidays, of course, are hospitals’ nightmares.’

  ‘And I presume this sort of thing goes on all over the country?’

  ‘I believe so. Particularly in hospitals near motorways. Ever since they opened our new clearway our accident intake has soared.’

  ‘It must place an intolerable burden on the staff. You work in shifts?’

  ‘We ‒ the nurses ‒ do. The men do what is to all intents a twenty-four-hour shift seven days a week. Officially they get here one half-day and one free evening a week. Both have to end by eleven for their night rounds. Then they have alternate week-ends from Saturday afternoon to Sunday night. Again, they have to be back by eleven. How they stand ‒’ I broke off to get up, quickly. ‘No, Bill, no! Don’t try and pull off your mask. I know it’s hot and uncomfortable, but it is helping you ‒ that’s it.’ He had stopped fighting me as my voice got through to him. ‘That’s better.’ I turned his pillows, propping him higher. ‘Another drink, Bill?’ I had to use a teaspoon. ‘Swallow, now. Good. Another swallow. Another.’

  Dr Curtis had been in four times. He was still up when the theatre eventually stopped at three-forty, and returned with the S.S.O. The latter was in theatre clothes, with his green cap pushed back on his red head and his mask limp round his neck. He looked as tired as a man could be and still stand upright.

  Bill did not recognize either man. ‘What’s the bastard trying to do, Nurse Dungarvan?’ he mumbled as Dr Curtis tried to listen to his chest. ‘Tell him to get the hell out of it.’

  ‘Take it easy,
son,’ said Dr Curtis. ‘I’m a doctor. I only want to help you.’ He waited while I soothed Bill. ‘All right, son? Do you understand now your nurse has explained? Good. Good.’

  When I went off that morning Bill did not recognize me. He did not even know his father. I left the General sitting stiffly in his hard chair, one hand on one stick handle, the other resting on his son’s bed. His set face was grey as the sky at dawn.

  All the Marcus night nurses were late for breakfast. Sister Dining-room was annoyed. ‘Really, Nurse Humber! I do not expect to have to remind a senior staff nurse that she should have more consideration for my dining-room staff!’

  The tables were nearly empty. We broke with tradition, and all four sat together. The Marcus night junior, though at the start of her second year, was on her first spell of nights. (No Benedict’s first-year student nurses did night duty.) She fell asleep over her sausage and bacon. Humber shook her. ‘Wake up and eat, Lewis. You’ve one more night before your nights off, and tonight can be as bad or worse. If you don’t eat you’ll be ill.’

  Gwenellen’s chubby and normally highly coloured cheeks were sallow with fatigue. ‘I haven’t had a chance to ask anyone ‒ how’s Bill Francis?’

  ‘Still with us.’ Humber answered for me. ‘At the rate he’s working up he’s heading straight for a crisis some time today.’

  Nurse Lewis had been chewing with her eyes shut. She roused herself. ‘What happens then?’

  Humber raised one hand, stiffening her fingers and slicing the air sideways. ‘He’ll shoot upwards, 105°, 106°, maybe higher. Then at the crucial point which only his body can decide, either he’ll drop’ ‒ she slapped the table ‒ ‘down to normal inside of a few hours, or his temp’ll shoot even higher.’ She did not raise her hand again. ‘That, of course, will finish him.’

  ‘How high can a temp go?’ asked Lewis.

  Humber shrugged. ‘Kids can reach fantastic heights and live. I’ve never myself known of any adult getting away with going over 107. Have you, Dungarvan?’

  I was finding this academic discussion unbearable. But as it had to be borne, I shook my head. ‘There was a woman in Hope who touched 107-8. She died. She wasn’t young. My pneumonia girl, Violet, hit 106-8 plus at her peak. She was down to 99 in two hours. She did very well.’ Nurse Lewis was keen and persistent.

  ‘But aren’t women stronger than men?’

  ‘Yep,’ grunted Humber. I said nothing.

  Gwenellen said gently, ‘There’s no question of his temp coming down by lysis?’ And before Lewis could ask what that was Gwenellen explained. ‘That’s when the symptoms subside gradually over several days.’

  ‘Could that happen?’ demanded Lewis.

  ‘Not in this case.’ Humber and I spoke together, and then we were all silent.

  Humber did not speak again until Lewis left us. ‘I’m sorry to have given you so little help last night, Dungarvan. I didn’t dare leave my poor sods for more than split seconds.’

  ‘I knew that. I managed all right ‒ I think.’

  ‘If I hadn’t known you could by last night,’ she retorted, ‘I’d have got me a spare staff nurse even if it had meant taking this bloody hospital apart. If I had still thought you as slap-happy as I originally assumed ‒ and bluntly, my child, you gave me the impression of being incapable of specialing a cold in the head ‒ if the Night Super had let me down I’d have gone over everyone’s head and rung Matron’s flat. I’ve done that once. It wasn’t popular. Nor is the death of a patient through incompetent nursing, as on that occasion I pointed out. Matron herself was sweet.’ She grinned quickly. ‘The Night Super’s never forgiven me. But as she needs me a hell of a lot more than I need her, we get along.’ She paused. ‘I suppose you heard I asked Sister Marcus to get you replaced?’ I nodded. ‘Know why you weren’t?’

  ‘Matron had no spares?’

  ‘It didn’t get to Matron then. Sister Marcus first had to talk to the S.M.O. and S.S.O., as inevitably their views mattered. The S.M.O. said you had been a very good night special in Hope. The S.S.O. said he’d no complaints, and he was dead against changing specials, as that always upset the patient. Sister told Matron, and you stayed. I’m glad about that. I was wrong, and I don’t mind admitting it. To be fair to myself,’ she added with a faint smile, ‘if you will insist on looking like the original swinging teenager it’s small wonder that the thought of trusting you with a really ill man put the fear of God up me.’ She jumped up, yawning. ‘I must go to bed before I fall asleep here like that child Lewis. See you both’ ‒ she corrected herself ‒ ‘I hope we see you back with us tonight, Dungarvan. I hope your poor sod makes it.’

  Gwenellen and I sat on drinking tea while the dining-room was cleared around us. Gwenellen remarked suddenly, ‘She always calls ’em sods when she wants to weep about them.’

  My body was in the dining-room. My mind was in Small Ward Two. I blinked. ‘What’s that?’

  She repeated herself, and added, ‘She cares about ’em.’

  ‘I know. You said she was good. She is.’ I stared into my empty cup. ‘Why didn’t you tell me she wanted me out?’

  ‘Why hand on bad news? Anyway, I thought she’d change her mind.’

  ‘Aline didn’t.’

  ‘Aline’s a born Cassandra, and she doesn’t like Humber.’

  ‘I wonder why not?’ I murmured, without really wondering or caring.

  Gwenellen realized that. ‘Humber told me Red Leland thinks he’ll make it.’

  ‘He’s only a surgeon.’

  ‘An M.Chir. and F.R.C.S. picks up some medicine. I back him.’

  I looked up. ‘Honey, you didn’t see what Bill Francis looked like this morning.’

  She had no answer to that. And since she shared Humber’s and my attitude to our job, she did not give me the kind of pep-talk Aline would have come up with in these circumstances. Aline was probably the most efficient girl in our set, and unquestionably the cleverest. If she did not marry directly she finished training, which was highly probable, as she liked the lads as much as they liked her, before long she would be a Sister Tutor. She had the right academic approach to nursing to make a first-class tutor, but not ward sister. Patients, to Aline, were fascinating mental problems to be picked up each time one walked on duty and put down directly one walked out of the ward.

  Up to a point we all learnt to do that. It had to be learnt, if we were not to turn into nervous wrecks. But every now and then some patient managed to break through the mental barrier erected by training, habit, and self-defence. Several times I had seen Gwenellen with that barrier down, but never Aline. Mine was down, now.

  The dining-room staff were getting impatient. Gwenellen rose slowly, patted my shoulder. ‘Come on over, love.’

  I expected to lie awake for hours. I fell asleep as soon as I got into bed, then woke to full wakefulness at three that afternoon. The weather had changed; it was much cooler, the sky was overcast, and it was trying to rain. I stuck it out for about an hour, and then could not stand another minute. We were not allowed to get up early without permission, but I didn’t give a damn for that. I got up and dressed in a sweater and pants, made my bed, then sat on the end and shook physically with anxiety. Then I faced the thought that by now he could be dead.

  I neither knew nor cared whether my distress for him was based on love for a man or love for a patient. I had loved other patients. A few men, more women and children. There was Violet, young Mrs King, old Mrs Evans, and all in Hope. Georgie, Marion, Paul, Linda ‒ the children’s faces floated through my mind. David Grant in Arthur. He had been twenty-one when he died of leukaemia, and I had had to help with his last offices and was then sent to escort his body to the mortuary. I had then been a night junior. My senior had not been a Humber. She had been furious when she saw my mask was wet. ‘A good nurse learns to control her emotions, Dungarvan!’ In the mortuary the night porters had swung open the huge white doors of the refrigerator and lifted the shrouded, stiffened body on to an
empty shelf. The refrigerator had ticked loudly. The senior porter had said, ‘Sign here, please, Nurse,’ and been kind when he had to wait until I could see well enough to sign that No. 4 was David Alistair Grant from Arthur Ward.

  I could not take any more thoughts, or my room. I let myself into our corridor, soundlessly, and crept down the back stairs and out of the back door without hearing or seeing any member of the Home staff.

  That door opened into one of the staff car-parks that lay between the medical-school library and our Home. I stood looking round vaguely and trying to decide what to do. Being off duty, I was forbidden near Marcus in or out of uniform. If I rang the ward and gave a false name someone might recognize my voice. But there must be some way ‒ there had to be some way of getting news. I’d go crazy if I had to wait until supper.

  ‘Jo, darling! What on earth are you doing here and up? I was just about to go round and ask Night Home Sister if there was a chance of your being called early.’

  I gaped at the speaker as if she were a mirage. She was a youngish woman of my own height, build, and colouring. She wore a cream linen suit, a black straw boater, and black gloves. The fact that I had never seen my aunt looking so elegant added to my impression that I was imagining this. She never visited Benedict’s. She said she didn’t hold with looking back.

  ‘Jo, what’s up?’

  In answer I did something I had not done in years. I flung my arms round my astonished aunt’s neck and burst into tears on her shoulder.

  She asked no more questions. She swept me away from the door, along a line of cars, into her aged scarlet mini, gave me a handkerchief, and let me cry it out. Then she said, ‘You’ve been on nights too long.’

  ‘It’s not that.’ I sniffed. ‘What are you doing here?’

  ‘I’m on my way home from Oxford, and thought this time I’d come through London and look you up.’ She handed me her powder compact, lipstick, and a comb. ‘Do your face, darling. Then tell me.’