The Quiet Wards

by Lucilla Andrews

  We walked to the doctors’ sink on the left of the door, and I waited while he washed his hands; then we walked up one side of the ward and down the other.

  The men smiled, ‘Evening, Doctor. You don’t get much sleep, do you?’

  He said he had enough, thanks, and what were they doing awake? He never talked much to the patients, but that was not odd, since he never talked much to anyone. But the patients liked him.

  ‘Gives you confidence, that big quiet chap,’ they said; ‘makes you feel safe, he does.’

  He looked at the charts, sometimes the notes, always their faces. He had seen them all that morning; he would see them all again the next morning; but once every night he walked round every surgical ward in the hospital.

  Nurse Fraser bustled down the ward on her way from the sluice to the linen-chute. She was carrying a closed bucket of soiled linen in each hand. We were just passing the wheelchairs, and the wide ward in that one point was narrowed by obstacles. He stood aside. ‘Evening, Nurse.’

  She gaped at him, and although the light was dim it was light enough for me to see the surprise in her face. She answered, ‘Evening, Mr Dexter,’ and in her surprise forgot to speak quietly, then remembered as she spoke and her voice trailed off in a squeal. She sounded as shaken as all juniors were by this civility from one of the two most senior resident doctors in Joe’s. She was new to Robert and Mr Dexter, but like every sensible pro had accepted the fact that first-year nurses are generally considered to be beneath the notice of any doctor. I saw by the jaunty way that she now carried her buckets to the chute that she did not realise that the present S.S.O. was invariably polite to all juniors. I was not going to disillusion her, I was glad her morale was being boosted. I knew she had been very frightened over the Admiral.

  When we reached the table he said, ‘I won’t keep you long, Nurse Snow, but I wanted to add some notes of my own to that chap Kerry’s.’

  I said that was quite all right, Mr Dexter, thank you, and sat down by the table, leaving Sister’s chair for him.

  Waiting for the S.S.O., and waiting on him when he was in the ward, was as much part of my job as Night Senior as bed making or taking temperatures. I sat beside him and waited for him to finish his notes; I wondered about his behaviour and why he was so civil, not only to the pros, but to all of us, not excluding his housemen. His irritation with Tom Thanet tonight had been so unusual as to prove his rule, and Tom had probably been as surprised as I by that irritation.

  The notes were taking him a long time, and as I now no longer needed to worry about the Admiral, since the boss himself was in the ward and had taken over from me temporarily, and I knew the men were all right, I thought about Jonathan Dexter’s good manners, and why he had this attribute, by no means common among doctors. And then I wondered why, despite this pleasing characteristic, I had never liked him or felt at ease with him. I decided it was because it was difficult to like a stranger. I had seen him around the hospital for years; he had been S.S.O. for the last two. And during the previous two months of this spell in Robert I had seen him nightly. But although I was now bosom pals with the house-surgeons and the surgical registrars, the S.S.O. was still a stranger. I was not alone in this. No one knew our John, and discussing him was our favourite pastime.

  I folded my hands in my lap and began surreptitiously unbuttoning my sleeves under my cuffs. He could not be much longer. I did not think he had noticed what I was doing, but without looking up he said, ‘I’ve nearly done,’ and went on writing.

  At length he capped his pen. ‘And Nurse Ash is staying with him all night?’

  I said yes.

  ‘Good.’ He leant forward on the table and propped his head on his hands. His fingers felt curiously at his theatre cap. He pulled it off, dropped it on the pile of notes in front of him, and pushed his hands through his thick black hair. When he moved his hand away some of his hair fell forward over his forehead. The table light beside him turned that bit of hair to silver. The light was false; in the daytime that streak was not silver, but white. He had a square-shaped face with a strong jaw line. His face was lined and white tonight, and his eyes were rimmed with red.

  ‘God,’ he said, ‘I’m weary.’

  I had noticed how tired he looked when he came in. He must have been unusually so, to admit so much human failing to one of his subordinates. He certainly looked years older than his age, which was thirty-seven.

  ‘Was he very difficult, Mr Dexter?’

  He was staring at his hands. ‘Pretty.’

  ‘Is he going to do?’

  He went on gazing at his hands as if he had never seen them before and was surprised to find them sitting at the end of his arms.

  ‘I wouldn’t like to say, Nurse,’ he said slowly, ‘I wouldn’t like to say. I had to do a great deal more to him than I cared to do. And he was pretty shocked before I started.’ He was silent. ‘There wasn’t much option,’ he added grimly, ‘but that doesn’t stop me wondering if my handiwork won’t give him the final push.’ He looked at me for the first time. ‘And he’s a nice old chap.’

  I might not like him, but I could appreciate the staggering and endless responsibility that was his.

  I said, ‘But it’s not your fault, Mr Dexter, if he’s run around with an ulcer that much too long and has forced you to operate.’

  He said, ‘No one forces anyone to operate. I thought it was a good thing. I still think it was a good thing. But I wish to God he’d come round.’

  I said I wished it too. I asked if he would like some coffee. Offering him coffee was another of my official duties.

  ‘No thanks, Nurse. I’ve just had supper. And I promised his wife I’d ring her again at eleven-thirty. And also’ ‒ a ghost of a smile flickered over his face ‒ ‘I could do with something stronger than coffee tonight.’

  I was curious. This was probably the longest conversation I had ever had with him, and the first opportunity he had given me to see how he felt about the job. I said, ‘Do these things often worry you this way?’

  ‘Not things, people.’ He rubbed his jaw. ‘The ideal, of course, is to reach the state of mind where you can obliterate the human angle. You do better work that way ‒ in theatre, that is. But every now and then you slip back. Or I do.’ He locked his hands on the table top. ‘I had a long talk with this old chap when he came in this evening. Like I said, he’s a good chap ‒ sensible. His wife’s the same type. I had a talk with her too. I had to tell her the score.’

  ‘What did she say?’

  He glanced sideways at me. ‘She said what they all say: “I leave it to you, Doctor. I know you’ll do what’s best.” And when they say that, sometimes I wonder: have I?’

  I looked down at my own hands to hide the surprise I felt. I was as shocked by the thought that the S.S.O. ever felt uncertainty as I would have been if one of the Metropolitan Police had stopped me in the street and told me he had lost his way.

  When I looked up again he was still watching me.

  ‘Tell me, Nurse Snow,’ he said, ‘what do you think of his chances?’

  ‘What do I think, Mr Dexter?’ I asked cautiously, wondering, unlikely though it seemed, if he was joking. British doctors, in or out of hospital, do not, as a rule, ask the professional opinions of nurses.

  He nodded.

  I thought a moment. ‘I don’t think he’ll die.’

  His expression was thoughtful, nothing more.

  ‘Why not?’

  ‘Because ‒’ I hesitated, ‘because he doesn’t look like it. I’ve noticed,’ I went on quickly to prevent the criticism I felt was bound to come, ‘that when people are moribund they have a special look about them. I know that you, Sister Robert, every one, is very gloomy about him and I’m sure you’re right. But I just don’t think he’ll die.’

  ‘Because he doesn’t look like it?’ he echoed. Then he smiled properly. ‘You know,’ he said, ‘you’re right. He doesn’t. He looks mighty ill, but he doesn’t look as he should look
. I was puzzled by that myself just now.’ He tilted his head to look down through the gap in the screens to the closed curtains round 18. ‘But I wish he’d come round soon. He’s got a good will. I’d like to get that will consciously working on our side. That’s partly why I’m hanging around here. That ‒ and the fact that I’m too dead weary to get out of this chair.’

  I half rose in my chair. ‘Would you like me to see if he’s come round yet?’

  He said simply, ‘No, thank you. Nurse Ash is there.’ So I subsided obediently and wondered how I should ever catch up on my night’s work, which still remained to be started, and who was the misguided person who had invented the rule that ordained that I must act as his quite superfluous shadow.

  He had picked up the case notes again and was flicking through them. He reached for his pen and drew a pair of small stomachs on one of the pages, then ornamented the drawings with arrows.

  ‘He’s a good build,’ he said to the drawings.

  ‘His face is very thin,’ I said. ‘I thought perhaps he was too thin.’

  ‘No’ ‒ he was shading the ulcer site now ‒ ‘from my point of view, you can’t be too thin. And surely you’ve noticed the tremendous strength wiry people’ ‒ he half turned, and his eyes rested on me as if I was a candidate for his surgery ‒ ‘like yourself possess. You’re an apparently frail and over-tall young woman ‒ but are you ever ill?’

  I said no, I was not, thank you very much.

  ‘While your friend Nurse Ash’ ‒ he wrote a balloon note and attached it to the first picture ‒ ‘who looks as sturdy as a rock, is rather the reverse.’ He blotted his work. ‘Of course, it’s hardly surprising that she should have been knocked flat by that accident, mentally; but I gather that, physically, she’s only survived her four years here by the skin of her teeth.’

  I said no, it was not surprising that that accident should have upset Nurse Ash and yes, she had been off sick a good deal.

  I was not surprised he knew she was a particular friend of mine; everyone in a hospital always knows everyone else’s affairs, but I was surprised that he should know so much of her medical history. Then I recollected that Dr Cutler, the Senior Medical Officer and the man who looked after sick nurses, was as notoriously chatty as his opposite number was uncommunicative.

  He said, ‘Have you ‒’ when we heard a small cough and Carol’s voice, raised slightly to break into an anaesthetised mind.

  ‘Just spit it out, Admiral Kerry, and take a deep breath. You’ll be all right.’

  Mr Dexter was out of his chair and down the ward before I had time to leave the table. He was a very big man, but despite his height he could move very lightly. He had won the interhospital heavyweight boxing cup for Joe’s for five years in succession in his student-houseman days; and as I shot after the tail of his flowing gown I wondered irrelevantly how many middle-aged general practitioners now practising in England had broken noses which they owed to our John.

  As I reached the curtains he remembered me. ‘I’ll manage alone, thanks, Nurse ‒ don’t you bother. I’m sure you have plenty of your own work to get on with.’

  I murmured, ‘Thank you, Mr Dexter,’ but doubted if he heard me. I returned to the table and picked up the pulse-book and a stethoscope with which to take the very belated 10 p.m. pulses as a house-surgeon called Peter Kier came in at the flat door and, catching sight of me, raised a hand.

  He waited at the ward door. ‘My boss been up, Gillian?’ he asked, when I joined him.

  ‘Here now. Behind 18 with Carol Ash. Do you want him specifically, or do you want to go round?’

  Nurse Fraser appeared at my elbow. ‘Shall I do those for you, Nurse? I’ve finished the laundry.’

  I remembered how much I had enjoyed wearing a stethoscope when I was a pro. It was about the one time I felt a modern, high-powered nurse, not an old-fashioned, inglorious cleaner.

  ‘Thanks, Nurse Fraser.’

  Peter grinned at her retreating back. ‘Tactful little soul, that child.’

  I did not tell him that I had not thought of that angle. I never disagreed with Peter. I said she was very tactful.

  ‘How’s the old salt?’

  ‘Coming round now. Perhaps we should join that party?’

  ‘Nightingale,’ said Peter quietly, ‘is your middle name, darling. Let’s.’

  The S.S.O. loomed ahead of us like a mammoth ghost. He nodded briefly at Peter, then jerked his head towards the curtains.

  ‘Round,’ he said; ‘so I’m pushing off. Nurse Ash knows what I want doing.’

  I began to follow him, but he shook his head. ‘I’ll see myself out, thanks. Good night, Nurse.’

  ‘Good night, Mr Dexter.’ I turned back to Peter, who was waiting for me. Peter smiled, and for an instant I forgot that I was in the middle of a long, wide, darkened ward; that it was past eleven, and I had not yet charted the ten o’clock pulses and antibiotics, or begun my first report for Night Sister. I stood and grinned at him idiotically, and then I saw that Carol was beckoning to me from outside 18’s curtains.

  ‘Jonathan D. wants him to have some morph. now, Gillian,’ she said, when I reached her. ‘I’d like to get it myself, because I’m getting claustrophobic, but I daren’t leave him.’

  I handed her the dangerous-drug cupboard keys.

  ‘Here. I’ll stay with him while you take the walk. My pro will witness for you.’

  Peter drifted close to me. ‘I want to talk to that chap in 26. I’ve seen he’s still awake. Then I’ll nip round tout seul and see you at the table later. All right?’

  I nodded and went in to the Admiral.

  He lay with his eyes closed, but he was not asleep. His colour was better and his jaw more firm than when I had last seen him. I touched his wrist gently, and he opened his eyes.

  ‘Where’s my little nurse?’ he asked.

  I explained that she would be back directly. ‘She’s gone to get something to make life a little easier for you.’ I asked how he was feeling.

  He said he really did not know. ‘I feel a trifle sore, Nurse, but nothing compared to what I felt before that large fellow patched me up.’

  His pulse was reasonably good. I checked his respirations, the transfusion, his dressing. Everything was going ‒ in hospital language ‒ as well as could be expected. He had closed his eyes again, so I sat down on his locker seat and waited for Carol’s return.

  I heard the man in 19 cough self-consciously, to show he was awake; and across the ward in 33, the docker with a repaired hernia began to hiccup. He often suffered from this at night, and I made a couple of mental notes concerning peppermint water and hot milk. I could feel rather than hear Peter moving round the ward, but intentionally I did not think of Peter. I made a point of not thinking of him on duty. It is difficult to concentrate on your job when your bones feel as if they have turned to water. Peter had had that effect on me since the first evening he took me out two years back.

  We had met in the theatre. I had been taking my first case and Peter was then a senior dresser. That morning I had scrubbed my hands and put on sterile gloves, then realised that in my nervousness I had forgotten to open the unsterile lid of a certain tin. Since I could not touch it myself, I had asked the nearest dresser, Peter.

  ‘Delighted to be of service, Nurse’ ‒ the operation had not yet started, and the dressers were ambling round the technically empty theatre ‒ ‘if you will come to the movies with me tonight?’

  I had been annoyed with him for the first and last time.

  ‘Please don’t be absurd.’ I hoped I sounded like Sister Theatre, and I had turned to the other dressers. ‘Will one of you open my tin, please?’

  The remaining quartet of young men chanted, ‘Not unless you go to the movies with our Mr Kier.’

  I had to have my tin opened, so I agreed, meaning to stand him up, but I had nothing to do that evening and my feet were hurting, so I thought I might as well enjoy a free movie. I enjoyed the movie and rested my feet; I a
lso fell in love.

  I was never certain what, if anything, Peter felt for me; I did know that he liked having me around and always took me out on the rare occasions when our off-duty periods coincided. I was fairly happy at the way our affair was going. At least it was still going, and there was no hurry. Peter was twenty-six and I twenty-one. Intelligent housemen do not marry while they are housemen; Peter Kier was an intelligent young man.

  Carol returned with the hypodermic syringe in a small dish, the drug-book, and a box of morphine ampoules.

  ‘Your pro has vanished. I thought we could cope here.’

  ‘Right.’ I checked the dose, then filed the top of one of the quarter-grain ampoules. Admiral Kerry watched interestedly. Carol disappeared to wash, then returned with dripping hands and fitted the syringe together. She moved to his side.

  ‘Just let your arm go loose, Admiral.’

  When it was over he said, ‘That didn’t hurt. How much blood have I had?’

  I left her explaining his treatment to him and took the empty syringe, book, and box of drugs with me. I stopped at the centre table to fill my name and the time in the D.D. book and began to count the number of ampoules remaining in the box, to check them with the number written beside the previous injection. Then I discovered Night Sister was at my elbow.

  ‘I’m sorry, Sister. I did not know you were in the ward.’

  She said she was not, officially. ‘I only want to borrow a grain of morphia for Charity. Can you spare four ampoules?’

  I showed her the box. ‘Easily, Sister. This is nearly full.’

  I watched her take four, made a note in the D.D. book, and passed it to her to sign; then I tucked the box under my arm and walked out of the ward with her.

  ‘How is that poor man Kerry now, Nurse Snow?’

  ‘Round, Sister, and fairly comfortable.’

  ‘Aye,’ she said, ‘I never doubted that he’d do. Mr Dexter is a grand surgeon.’

  I said Mr Dexter had seemed very worried tonight.

  Sister blinked. ‘He would not be a good surgeon if he did not worry, Nurse. Sister Theatre was telling me a while back that she had not seen the like of that abdomen.’