The Quiet Wards
Page 13
‘For goodness sake,’ she said sharply, ‘leave me a smattering of pride! I appreciate that you’ve managed to persuade one man to bring me here tonight; you really don’t have to bulldoze another into dancing with me!’
‘Oh Lord,’ I said, ‘I’m sorry ‒ I’m bats ‒ I just didn’t think. And honestly I didn’t persuade Peter to ask you. He thought it up for himself. You know that.’
The flame died, and her eyes were as calm as ever. ‘I know you weren’t thinking, ducks ‒ you never do,’ she said quizzically, ‘do you? But it mightn’t be a bad idea if you did.’ She shut her compact with a snap. ‘And you needn’t worry about your young man’s behaviour. He won’t harm ‒ me!’ She walked away quickly before I had a chance to ask her what she meant. I wished I had called her back. Her words niggled in my brain for the rest of the night, and when I woke up next morning they were still there.
Out-Patients was very busy that morning, although it was Saturday. Sister was off for the weekend, and despite the rush there was an air of high holiday in the department.
I did not see Peter during the morning. I did not know whether he was avoiding me, or in the theatre. Probably the latter. Peter’s bouts of bad temper seldom lasted long. I was glad not to see him. I had had enough on my mind without his disturbing presence, and I was tired of the well-intentioned, disinterested advice of my friends, old and new, on the subject of my future.
Tom was assisting in an eye clinic. Half-way through the morning he came over to the empty Children’s Room.
‘Have you a spare ophthalmoscope, Nurse? My battery’s just packed up for me.’
I gave him our instrument, and he murmured, ‘No hard feelings, Gill?’
‘None at all. All that’s bothering me this morning are my poor feet.’
He said, ‘That’s a bit of a dirty crack to your dancing partner, Nurse Snow.’
John came out of the office, where he had been writing notes.
‘You wanting me, Thanet?’
‘No thanks, sir,’ called Tom cheerfully. ‘I’m just scrounging an ophthalmoscope from Nurse Snow and fast returning to my eyes.’
John walked down the room and stood in the doorway. ‘No more children coming along, Nurse Snow?’
‘No, Mr Dexter. All the appointments have run through.’
I thought he would go, but for once he seemed in no hurry. He stayed where he was and watched the steady trickle of patients pass on their way to the main entrance.
‘Place is clearing quickly this morning,’ he remarked.
I agreed, I would have liked to have added that the place always ran smoothly when Nurse Blakelock was in charge, but although it was true, it would have been too obvious a crack. It would also have been very bad manners, since I knew of his relationship with Sister; and since he was invariably polite to us it was impossible, as well as inexcusable, to be deliberately rude to him. I went on tidying the comic-cupboard.
He looked round to see what I was doing. ‘Enjoy yourself last night, Nurse?’
‘Yes, thank you.’ I wondered what he had thought when he saw Tom kissing me.
‘That’s good.’
I asked him the same question. He said, ‘Thank you, I did.’ He looked at his watch. ‘I’m due in the theatre in twenty minutes. I’m going by the way of the canteen. Would you mind telling Nurse Blakelock that I’ll be out of action in the theatre for the rest of the morning, and if she wants anything in my line will she contact Mr Henderson?’
I shut the cupboard. ‘Yes, Mr Dexter.’
‘No hurry,’ he said; ‘when you next see her. She’s not likely to want me. The clinics are done.’ So I opened the cupboard again, and he walked away down the corridor.
I finished the cupboard in a few minutes and went in search of Blakelock. I found her in Sister’s office.
‘Hallo, Snow. Your kids finished?’
‘All gone, Nurse.’ I gave her John’s message.
‘What fun for the theatre. I’ll bet they feel just like a long list this morning.’ She asked if I had enjoyed the dance. ‘I hear it went well.’
‘Very well. You should have been there, Nurse.’
Blakelock grinned. ‘Not I, my child. I like my bed at night.’ She said she had never been a one for dancing. ‘I’m too heavy,’ she said simply, ‘and I start puffing.’
‘Nonsense, Nurse. You nip round O.P.s fast enough without puffing.’
She said that was her armour plating. ‘But you can’t wear whalebone under an evening dress ‒ so dreadful for your partner!’ She asked how Sister had looked.
‘Out of this world. She really did.’
Blakelock looked at the form she had been filling in. ‘I wonder if she’s going to step out of this world ‒’
‘Nurse, wouldn’t it be bliss? And you could be Sister O.P.s.’
‘Hush,’ she said severely, ‘what is all this, mutiny?’ She relaxed. ‘Be rather fun, Snow. Fun all round.’
I said it would be splendid, and we all thought she, Blakelock, would make a magnificent Sister O.P.s. I asked her what she wanted me to do.
She said, ‘Thanks for the kind word. I hope Matron agrees. I’ll admit I’d like it myself.’ She looked up at the clock. ‘Twelve. Perhaps it’s safe to start the extra cleaning,’ she said thoughtfully. ‘I think it should be ‒ but I always suspect a morning that starts as badly as this one did and then trails off by midday. We’re too quiet.’ She looked past me and through the open door. ‘Or have I spoken too soon?’
I turned. Tims, the porter, was streaking down the corridor from switchboard. ‘Message from Sister Casualty, Nurse Blakelock. Can you take a motor-cycle crash in the emergency bed? A young lad. Sister says as Casualty is full and hasn’t a bed.’
Blakelock stood up. ‘Yes, we can. The fracture-room bed is ready. But why is he coming in here? Surely if he’s a bad crash he ought to go straight to the wards and by-pass us?’
Tims said he couldn’t say, Nurse, he was sure ‒ but he’d ask the Sister, and raced back to telephone.
Blakelock shrugged. ‘I thought we were too quiet. Let’s go and investigate.’
I followed her to the main entrance. Tims joined us immediately.
‘Sister Casualty says as she’s much obliged Nurse and the ambulance is coming alongside directly.’ Tims had been in the Navy at some time, and in moments of stress always slipped back into nautical phraseology. ‘Sister said to tell you as she’s sent for Mr Henderson to come here, and she’s asked the theatre to tell Mr Dexter.’
Blakelock and I looked at each other. Sister Casualty never panicked; if she had sent out a general alarm to the surgeons she must take a very serious view of the man’s condition.
‘Where’s the injury, Tims?’ asked Blakelock. ‘And how bad?’
‘Head,’ he said briefly. ‘Sister says she doubts as if he’ll reach a ward, which is why she wants him in a bed here real quick.’ Blakelock and I looked at each other again and waited for the ambulance. There was nothing we could do until the men unloaded the stretcher. The accident bed in the fracture-room was always ready for something like this; the thermostatic blanket was on; the hot water bottles refilled two-hourly; a radiant-heat cradle; spare blankets; a dressing trolley; oxygen; a transfusion stand and setting; and a sheaf of blank notes were all there, waiting. Keeping that bed in readiness was part of the normal routine of the senior probationer in Out-Patients.
There was nothing to be done but wait until the man arrived; and when he arrived, and the careful ambulance men wheeled in the stretcher-trolley with the help of Tims and an anxious young policeman, and we all lifted the boy on to the bed, it was unhappily obvious that there was little anyone could do.
Mr Henderson arrived as Blakelock covered the boy’s head with fresh sterile towels. I looked up from the oxygen mask I was holding in position. ‘Do you want me to move this, Mr Henderson?’
‘Just let me have a look at his face’ ‒ I lifted the mask ‒ ‘right. Give him some more, Nurse.’ H
e touched what had once been a forehead with his forefinger, gently removed a corner of one of the towels. ‘My God,’ he said softly.
The room was very quiet, the only sound the hiss of the oxygen.
‘How fast was he going, do you know, Officer?’ asked Mr Henderson.
The policeman shook his head and stared at the floor. ‘Not less than sixty I’d say, sir.’
Someone touched my arm. I glanced round and saw Blakelock was beside me. Her face was pale green, and there were beads of sweat on her forehead.
‘Sorry, Snow,’ she whispered, ‘but I’ll have to leave you to ‒’ Her words faded and she went down. I caught hold of her with my free arm but she was too heavy for me. The policeman moved quickly, ‘You leave her to me, Nurse.’
Tims was by the door. ‘I’ll fetch along Nurse Smith.’
‘Thanks, Tims.’ The policeman was dealing competently with the unconscious Blakelock. I looked back at the mask I was holding.
Bill Henderson said, ‘I’ll hang on to that, Nurse Snow. Can you clean his head up as Nurse Blakelock was doing?’
‘Yes, Mr Henderson.’ We changed places and I switched my mind off everything but my hands.
I swabbed, cleaned, swabbed, cleaned mechanically, and shut all the pigeon holes in my brain that might, if open, remind me that I was dealing with a human being. This isn’t a boy’s head, this is just something that has to be cleaned; that isn’t a skull, it’s just bone; and don’t think, don’t think, don’t think. I had used this formula before; it was the only way I was able to achieve the necessary detachment to do some of the things we had to do. I could tell by the carefully controlled breathing of the man working with me that he was thinking what I was thinking, and feeling what I was feeling.
The ambulance men were still there, watching, waiting, although there was nothing they could do. Their kind, experienced faces were pale, their eyes heavy with fear. I had finished cleaning.
‘What about his family?’ I inquired.
Mr Henderson had fixed the mask and was preparing an injection.
‘Did you contact them?’ he asked the policeman.
The policeman said they had got a message to the boy’s father. ‘He and his wife are coming directly, Doctor, but they’ve got to cross London. It’ll take ’em a tidy time to get here.’
Mr Henderson looked at me. ‘I hope to God they make it.’
‘Yes.’ I went on with the new dressing I was applying.
He gave the injection. ‘Mr Dexter know about this chap?’
‘Sister Casualty sent a message to the theatre. He may have started.’
He nodded. ‘Probably.’ He took off his stethoscope. ‘I’m going to give him some more of that. I’ll use a long needle and get it into the muscle.’ He looked at the trolley. ‘Have we got enough coramine here?’
‘There’s a full box on that lower shelf.’
We gave him morphia; we gave him coramine; intravenous saline; continuous oxygen. We gave him everything else that could be given; everything that modern medicine and a modern well-equipped hospital could provide; but he had hit the road with an uncovered head at fifty or sixty miles an hour and there was nothing that was any use.
John came in about twenty minutes later. He had come straight from the table and had not even stopped to remove his white over-boots or pull down his mask. His boots squeaked on the rubbered floor as he came into the room. He stood in silence looking at the boy, and then as I lifted the dressing, at that broken head, he said ‘The poor young devil,’ and nodded to me to replace the dressing. He turned to Henderson. ‘What have you done?’
Bill Henderson told him. ‘I didn’t bother about taking any pictures.’
John shook his head. ‘No need for that. We can see all we want.’ He glanced at me. ‘What do you make his pulse now, Nurse?’
For the last few minutes I had been taking his radial pulse continuously. ‘I can’t get it accurately now. It’s barely perceptible.’
He nodded again without speaking, then remembered his mask, and pulled it down.
Bill Henderson turned up the oxygen, and the bubbles of air danced in the flow-water; John walked to the foot of the bed, which was raised on the highest blocks we possessed. He took the foot off the blocks and held it up higher. The policeman came forward and they held it at an angle that was nearly vertical.
‘This doing anything, Nurse?’ asked John.
‘I’m afraid not.’
Bill gave him some more coramine; he used the long needle again and as the drug touched the heart I felt the beat under my fingers quicken very slightly and then fade again. One of the ambulance men was speaking to John. ‘Shall I hold that for you, Doctor?’ They changed over and John took Bill Henderson’s stethoscope from the trolley.
‘What did you get last time you listened, Bill?’
Bill told him, and again they looked at me. ‘What is it?’
I said, ‘Fading.’
They stood together watching the injured boy. John said very quietly, ‘What a damned waste.’ Later I remembered that it was the first time I had ever heard him swear. Now I shifted my fingers to get a better feel of his pulse. I moved my fingers three times, then twice more, then I said, ‘I can’t get it at all now.’
John fixed the stethoscope in his ears. ‘I’ll try this way.’ He bent down and listened for the apex, then the aortic beat, he moved the end piece to the lungs, and then back to that eighteen-year-old heart. He took off the stethoscope and turned to the two men holding the bed. He said, ‘Thank you very much. You can put that down now.’
Lisa came into the room and closed the door quietly.
‘Mr and Mrs Downs are here to see their son.’
John took off his cap and pushed his hand through his hair. ‘Keep them in the office, Nurse Smith. Say we’ll be out immediately.’ He looked at me. ‘You had better come, Nurse Snow. Mrs Downs will want to see you.’
I said, ‘Yes, Mr Dexter,’ and followed him from the room, and the ambulance men moved their feet and avoided looking at us as we went by.
Lisa was outside the office door. ‘I’ll take over in there,’ she said. She caught my eye, and I shook my head. She winced visibly, then walked away to the fracture-room.
His parents were young, very young to have a boy of eighteen. Mrs Downs jerked out of her chair and caught my shoulders with both hands. ‘Nurse ‒ can I see him now? He’s all right, isn’t he?’ she gasped fearfully. ‘He is all right? It’s not too bad? Say ‒ please say’ ‒ her voice cracked ‒ ‘that he’s not too bad?’
She was shorter than I, and over her shoulder I saw her husband stand up slowly, his eyes fixed on John’s face. ‘How is he, Doctor? How is the lad?’
John said gently, ‘Won’t you both sit down, please?’
Mrs Downs, still clinging to me with one hand, spun round. ‘Oh, Doctor, can’t I see him first?’
He said, ‘Please sit down ‒ I want to talk to you ‒ please.’
She dropped back into her chair, her hand in mine. Her husband sat down stiffly, as if he was a very old man.
John pulled forward a chair and sat close to her, facing them both. ‘I am very, very sorry,’ he said ‘to have to tell you this ‒’ His voice was deep with compassion as he told them.
They sat very still. Mrs Downs stared at him uncomprehending, and then raised her eyes to my face, ‘It isn’t true, Nurse?’ she asked softly, ‘Tell me, please tell me ‒ it’s not true?’
I said, ‘I’m sorry ‒’ then broke off. What else was there to say? She did not cry; she gave a small gasp and then buried her face in my apron lap as if she was a child. She was not wearing a hat, and her hair was curly and very fair. I stroked her hair as if she had been a child, and felt my body shaken by her tearless sobs.
Mr Downs was twisting his hat in his hands, turning it over and over. He did not look at his wife. He looked at John.
‘I gave him that machine for his birthday,’ he said, ‘I ‒ gave it to him.’
John took them out to the car and waited at the hospital gates as the car drove away. Blakelock came down the corridor. ‘Leave that clearing up in the fracture-room to us, Snow,’ she said. ‘Just straighten the office, will you?’
John was back in the department. He said, ‘I’ll sign that certificate and the forms for you now, Nurse Blakelock.’
She said, ‘Will you see to them, Nurse Snow?’ and went back to the fracture-room.
John followed me into the office. ‘Let’s have them and get them over.’ He sat down wearily at the desk and tugged at the strings of his mask which was hanging round his neck. The bow on the upper strings had become knotted. He untied it slowly.
I found the necessary forms and put them, with my pen, in front of him. He picked up the first form. ‘Do you know his Christian names?’
‘Richard Samuel.’
‘How did you have time to find that out?’
‘The policeman got them off his driving licence. I heard him telling Tims for the admission book.’
‘Right. Eighteen?’
I said, ‘Yes.’
He stopped writing and laid one hand flat on the desk. ‘What the devil can you expect if you give a boy that age a powerful machine? Of course he’ll flog it ‒ and of course he’ll crash. Do you know what kind it was?’
‘No.’
He told me. ‘In case you’re not up in these things that’s just about the fastest machine on the road. A lovely job ‒ if you use them sensibly. But who has any sense at eighteen?’ He stared at his hands. ‘We’re all supposed to be so damned clever ‒ all of us ‒ and what happens? A boy plays the fool with a bit of machinery, and we can’t do a thing. We just have to stand around and watch him die.’