Hospital Circles

by Lucilla Andrews

  Dickie read the figures and calculated fast. ‘Mum! In five years this’ll come to over two thousand pounds! Gosh! I never thought I’d cost so much! Did you?’

  ‘It crossed my mind, darling. More toast?’

  I looked at the letter again. ‘Dickie, why are you Richard Simon Michael?’

  ‘’Cos my dad was Simon Richard and Grandpa was Michael. Shove us the marmalade, Jo.’

  Margaret smiled at me over the table as if she had read my mind and was too happy to be anything but amused by the fact. I returned her smile. ‘I like the name Richard.’

  ‘Now there,’ said Margaret, ‘I do agree with you, Jo.’

  Chapter Six

  CASUALTY HAS A NAUTICAL AIR

  Sister Casualty had been two years junior to Margaret in training. After she had finished midwifery and two years as a Benedict’s junior sister she had joined the Royal Navy as a nursing sister for a few years. She had returned to Benedict’s and been appointed to Casualty after working for six months with the retiring Sister Casualty, five years ago.

  She described her R.N. experience as ‘not her tot of rum’. ‘Never seemed to nurse anything but gastric matelots. Nothing against matelots. Damn good chaps. Never much cared for gastrics. But admin, that’s my right berth.’

  The Royal Navy had left its mark. In Casualty we did not report for duty, we came aboard; we worked watches, not shifts; when we went off duty we went ashore; on our days off we took the liberty boat.

  Sister Casualty off duty invariably wore a trouser suit, white shirt, and silk cravat in assorted colours. As she was just under six foot tall and very slim, wore her dark hair closely cropped, and her face though free of make-up was not unattractive, the result was certainly striking. In uniform she looked very dignified and very nice, and she ran Casualty so efficiently that without her various little ways her professional skill would have been enough to account for her already being a hospital legend in her own lifetime.

  She was very kind to the patients, and for that they would gladly have forgiven her personal idiosyncrasies, if they noticed them, which was unlikely. She was ‘the Sister’. To nine patients out of ten she was the first hospital sister with whom they had been confronted, and the great majority, when they walked, were pushed, or were carried for the first time through the double doors of our main entrance, were very apprehensive and trying to hide the fact. How they hid it depended largely on their education. The less-educated showed a nervous awe; the better, generally, open belligerence. They knew their rights and they were going to get them. The hospital belonged to them. Hadn’t they paid for it with their National Insurance stamps, income tax, and rates? They had heard how hospitals messed people about with all that unnecessary waiting and medical jargon, and if anyone tried to treat them like illiterate peasants there’d be a letter in the post to some M.P. before the day was out!

  Sister Casualty handled them all magnificently, each patient differently, and yet each one as if he or she was her sole reason for taking up nursing. She had a remarkable memory for names and faces, which helped, but above all it was her genuine kindness that not even the most irate could withstand. ‘No question,’ they told each other in educated voices, ‘that woman’s doing her best for us. One can’t blame her for faults in the system.’ Which was true.

  On my first morning she had taken one look at me. ‘Ah, yes, Dungarvan! Clearly a relation to Maggie Ellis, née Dungarvan. Your aunt, eh? God! That makes me feel long in the tooth, gal!’ She patted my arm. ‘Welcome aboard! In which other departmental establishments have you previously served?’

  ‘Out Patients and the General Theatre, Sister,’ I replied, resisting the urge to salute by holding my hands more tightly behind my back in the correct position for any Benedict’s nurse when talking to a senior.

  ‘Both’ll help you here, if not very much. You’ve been sent to join my Accident Recovery Room team as soon as possible, but I refuse to allow my gals near my A.R.R. until they’ve found their sea-legs. I’d say that’ll take you around three weeks. It may have to be less if we are rushed. For today, Staff Nurse Fields will be your guide, comforter, and friend. What Staff Nurse Fields becomes tomorrow depends on you. Tomorrow you will do alone the work you’ve been shown today, but under her supervision. By the third day I expect third-years to work alone, and if you slip up, gal, I’ll have your guts for garters! Got that?’ That time I had to stifle an ‘aye, aye’.

  ‘Yes, Sister.’

  ‘Good.’ She patted me again. ‘Now, your watches. You’ll be on from 7.30 A.M. to 4 P.M. this week; next week, 1.30 P.M. to 10 P.M.; third week, 3 P.M. to midnight. Then back to square one. Right?’

  ‘Yes, Sister.’ It could not have suited me better. If Bill’s leg went according to form he should be back in town for his first follow-up clinic when I started my second all-day shift with its row of free evenings. I had hoped there would be a letter from him waiting at Benedict’s when I returned last night. I was a little disappointed it had not been there, but I was quite sure he would write again in the next few days. Having said so much in his first letter, he was bound to follow it up. If not, he would never have written at all.

  Sister Casualty said now we had everything ship-shape, how was her old oppo Maggie Ellis. ‘Nice gal. Good senior. Did her own work and didn’t expect me to clear up after her. You clear up after yourself, gal? You’d better, if you know what’s good for you! So your aunt’s still nursing? Good. Always thought it a wicked waste of a good nurse when she chucked it to marry. Still, Simon Ellis was a Benedict’s man.’

  She was voicing not only her own views, but those of authority at Benedict’s. Authority never ceased to sigh when nurses left to marry, but if Benedict’s nurses married Benedict’s men, then authority sighed a little less loudly.

  Staff Nurse Fields was the most senior of the five permanent Casualty staff nurses and Sister's official stand-in. She was in the same year as Humber, and had the same brisk efficiency, but was much more friendly. She was married, which probably explained that. Authority might prefer single nurses, but every student nurse I ever met preferred to work under a married senior. When Sister handed me over Mrs Fields thrust a sheaf of lists of names at me. ‘Don’t lose these. You’ll need ’em. It’ll be days before you remember who’s who, but don’t let Sister catch you checking up from your lists after your first week. That top list has the most vital names. Those in blue work in the Hall, those in red in the A.R.R. Unit. The most important name in the Hall is Dr Jones, the Senior Casualty Officer. In the A.R.R. Unit it’s Mr Waring. He’s the Senior Accident Casualty Officer.’

  Dr Jones was a Member of the Royal College of Physicians; Mr Waring a Fellow of the Royal College of Surgeons. Both men were permanent members of the department with no ward responsibilities.

  Mrs Fields said, ‘As by some miracle the A.R.R. Unit is empty, I’ll take you there first.’ She opened a door. ‘The Cleansing Theatre. This is where all bad accidents come first and have their clothes removed and first transfusions. It’s really here that, if their lives can be saved, they are saved.’ She closed the door, opened another. ‘The Intensive Care Room. Accidents come here from the C.T. when they are not fit to stand the journey to the wards straight away.’ We moved on again. ‘This whole Unit has grown from the one room originally set aside for road accidents some years ago. Then there were no permanent senior residents in the department as now, and all the housemen had to double-up as C.O.s (Casualty Officers) here and housemen in the wards. They still do that in the Hall, but Mr Waring has two registrars, two house-surgeons, and one anaesthetist on his permanent Accident team. Plus four nurses. It may seem a large Accident Staff. Often we could use double.’ She opened another door. ‘Burns.’

  Burns were my Achilles heel. I looked apprehensively at the five operating-type tables spaced far from each other round the wide tiled room. Each table was fitted with transfusion stands and connected up to the piped oxygen laid on throughout Casualty.

  ‘
Do you ever have to use all the tables at once?’

  ‘Often enough for five to be necessary.’ She glanced over to the two male nursing orderlies testing an oxygen tent in the far corner. ‘Isn’t that so, gentlemen?’

  One of the orderlies was West Indian. His name was Nugent, and he had a beautiful voice. ‘So very right, Nurse Fields.’ He turned to his smaller, stouter colleague. ‘Isn’t that the truth, man?’

  His colleague, Luis, was a Spaniard. He had large, sad brown eyes. He raised them, expressively.

  ‘Aie, aie aie. Remember, last week, no? Those children, no more than babies, and the mama had gone shopping and left on the oil-stove, no? Aie! How they looked!’ He crossed himself.

  I asked, ‘How did they do?’

  The men looked at Mrs Fields. She looked at the empty tables. ‘They didn’t.’

  We were just finishing our tour of the many dressing, examination, and clinic rooms off the Hall when Mrs Fields was summoned to Matron’s Office to discuss her next holiday dates. Sister told me to wait outside her open duty-room door and watch all that was going on. ‘No better way of learning any new job.’ She turned as two uniformed policemen came in through the main entrance. ‘Have you gentlemen come to see the lady who fell backwards off a bus and hurt her knee twenty minutes ago? You’ll find her in Room 3. Know the way?’

  ‘Yes, thanks, Sister.’

  Sister explained to me, ‘The poor old dear’s in a fine twitter as she thought the bus was stopping, not starting ‒’ Sister shot off to meet an anxious young woman with a baby in her arms and a small tearful boy hanging on to her skirt. The boy had a messy bandage round his right knee. Sister crouched by him. ‘And what have you been doing to your knee, sonny?’

  ‘He will climb that old fence back of our buildings, Sister. I’ve told him not to, and so has his dad,’ replied the mother, ‘but you know what boys are!’ She stroked back her baby’s hair. ‘I’m sorry to bring the baby, but I had to, as I’d no-one to leave him with.’

  ‘That’s all right, m’dear. Very sensible of you to come up, as we’ll need your consent for any treatment the doctor may decide on for your lad.’ She ruffled the boy’s hair. ‘Like climbing, do you, sonny? Jolly good fun, isn’t it, when you don’t fall off! Let’s have a peep under that bandage ‒ no ‒ I won’t hurt. Ah. Well, now, when you see the doctor, if he decides to mend you with one or two stitches, you tell him I said, could he please give you a stitch to take home in a matchbox? You’d like that to show your mates, wouldn’t you?’

  The child had been about to cry again. He stopped in mid-wail. ‘You bet! Smashing!’

  Sister sent them off with one of the Hall nurses and rejoined me. ‘I’m always glad to have mothers come up with their nippers. You’ll be surprised at how many moppets we have bring themselves up. The very young have astonishing guts, but there’s so little we’re allowed to do for them without signed parental consent. Ah ‒ an ambulance. This’ll be another knee. You see.’

  She was right. A few minutes later a youth with a shattered left knee-cap was wheeled on a low-slung ambulance trolley into the Cleansing Theatre. He had come off his motor-bike.

  Sister said, ‘Don’t ask me why things always come in in triplicate. Can’t explain. Fact remains, they do. Now what?’ The oldest of the three porters running the glass-fronted lodge just inside the main entrance was putting a middle-aged woman with a blue hat into a wheel-chair. Sister returned after escorting the woman and porter into one of the examination rooms and leaving a nurse in her place. ‘Dr Jones’ll be in to look at that woman directly, Paddy,’ she told the old porter as he ambled up. ‘I’ve no doubt he’ll ask Dr Curtis to admit her to a cardiac ward.’

  ‘Sure, now, and there’s no doubt in my mind at all, Sister! And hasn’t she the very face of a heart?’ He went on to his lodge.

  Sister smiled at his blue-jacketed back.

  ‘Paddy’s an old salt. Knew directly I saw him put her in a wheel-chair that we’d a cardiac on our hands. Paddy doesn’t put a patient in a chair at sight for nothing. He’s far too good a diagnostician. Old Cas porters get that way. You can always trust ’em, gal. And what’s he want now?’ The old porter was returning, shaking his head gloomily. ‘Well, Paddy?’

  ‘A bag, Sister. You’ll be needing a paper bag.’

  Sister disappeared to talk to one of her staff nurses. Later she explained the reason for the paper bag.

  ‘One of these.’ She showed me a large bag made of toughened brown paper with a sealing device at the mouth.

  ‘These take the clothes of any vermin-infested patient.’ My expression amused her. ‘Did you think we no longer get ’em in alive?’

  ‘Yes, Sister. My aunt has told me they still admitted quite a number of patients in that condition in her day, but I thought things had changed.’

  ‘Technique’s changed, m’dear. So has treatment. We’ve new equipment, new drugs. But not new patients, because patients are human and human nature doesn’t change. Some day, when you’ve time, ask one of the Sister Tutors to let you have one of the copies of the Casualty records for the last hundred years. You won’t find very much difference in the type of patient we had in then, to now.’ She looked round the crowded Hall. ‘A hundred years ago they were carried in after coming off their horses, or being knocked down by carriages. There was a lot more tetanus, but no more than was carried in here fifty years ago in the First War. Twenty-five years ago they were knocked down by bombs. Now they get knocked down on the roads. The internal-combustion engine probably chews them up a lot more than anything that’s gone before, but the patients themselves don’t alter. The brave are still brave, the cowards cowardly, and the dirty are still alive from head to foot. So if you ever start scratching in Casualty don’t dismiss it as the odd gnat-bite. Directly you go ashore have a bath, send everything you’ve been wearing to the laundry, and wash your hair. Mercifully, human lice still abhor cleanliness.’

  Gwenellen and I were the only members of our set on days. As Gwenellen now worked in the Out Patients Department, which closed at 6 P.M. from Mondays to Fridays and at 12.30 on Saturdays, she was enjoying one of the most envied and regular off-duty shifts in the hospital. Having all my evenings free that week, we spent most of them together. We agreed that without our set we felt as out of touch as two visitors from outer space. Gwenellen was seeing next to nothing of her fiancé, Tom Lofthouse, as the surgical side was having another of its regular breathless rushes. ‘Much more,’ said Gwenellen, ‘and I’ll begin to wonder what my beloved looks like. Aline sees more of him on nights in Marcus.’

  ‘How’s she getting on? I’ve not set eyes on her since I got back.’

  ‘When does anyone see the night girls, love? I’ve only run into her once when she was coming back from nights off. She was in fine form.’

  ‘Despite Humber?’

  ‘They’re still fighting it out.’

  ‘Poor Aline!’ Gwenellen rolled her eyes.

  ‘See here, I know you liked Humber,’ I protested, ‘and so did I, eventually, but she’s got a hellish bitchy exterior.’

  ‘Aline knows how to take care of herself. Talking of bitches, how are you getting on with old Sinbad in Cas?’

  I smiled. ‘I wouldn’t call her a bitch.’

  ‘Indeed, nor would I, love,’ she replied in her most placid manner, and then we both laughed, rather unkindly. I said it was probably a good thing Cas was always so busy, and Gwenellen, having already worked in Cas, advised me to avoid the splint room on the rare quiet night. ‘Have you heard Daisy Yates is joining you in Cas when she gets back from holiday this week-end?’

  ‘No. Good. I like Daisy. Why did no-one tell me? No-one ever tells me anything!’

  ‘You’re a fine one to talk!’

  I thought of Bill. I had talked a great deal to her about my nights in Marcus. I had tried to be discreet, as the subject was professional dynamite even when discussed in private with a great friend. I had had to talk about him to someone to e
ase my mind. He had still not written, and it was now beginning to worry me. ‘What’s that supposed to mean?’ I asked carefully.

  She asked why I had said nothing about that accident on the bypass, or seeing Old Red and General Francis on my holiday.

  I was astonished and relieved. For an ugly moment I had been convinced she had guessed the real reason for my avid professional interest in Bill Francis. As I did not now want her to guess my real reason for keeping quiet on this other matter, I used the truth, if not all the truth. ‘That accident was so bloody awful I didn’t want to talk about it. How did you hear?’

  ‘From Aline. She had it from your ex-special p, and he had it from his father. Old Red must have told the General. Ghastly, was it?’

  ‘Yep.’

  ‘I should have worked that out for myself. I saw an accident at home once.’ She shuddered. ‘I can still throw up. I haven’t Aline’s academic approach either. She, of course, thinks you’re just being dead crafty.’

  ‘Why?’

  ‘Because she’s still fixated with her idea that Old Red’s been carrying a torch for your aunt for years, and it’s now burst into a fine new flame. She thinks you don’t want to spoil things with careless talk. I think that’s a right load of old codswallop, and Tom agrees with me. If Old Red really wants your aunt, why wait all this time? They’ve both been free for years. Admittedly, he doesn’t yet earn a fraction of the money a man of his age and experience would expect to earn outside, but he is on the way to the real big-time. And even now, as he never has time off for spending the twenty-something quid a week they’ll dish him for the one-hundred-and-twenty-hour stint he puts in most weeks, he could just afford a wife and kid. Look at Chubby Curtis.’

  For once, I thought before speaking, and so was able to refrain from remarking tritely that it took two to make a marriage. Aline’s insight underlined my conviction on holiday that this was one tale not for retelling. If by one careless word now I backed up the rumours Aline was bound to be spreading at night, by tomorrow morning Tom Lofthouse, a chatty lad, would have it all round the Doctors’ House. The men gossiped as much and as scurrilously as ourselves. Any single senior resident had to accept as part of his job the fact that his juniors were going to speculate constantly on his lack of a visible sex-life. If any gossip reached Red Leland I suspected he would shrug it off and forget it. But not Margaret. If she arrived in Benedict’s to find herself established as his mistress, future wife, or both, she would promptly develop a new set of anti-Richard complexes to add to those she already had, and Heaven help his chances with her then!