Dear Connie,
Don’t fret when you read this. I got wounded in the action this morning – shot in the arm. I AM FINE. They’ll send me home for a while. Please can you tell Ma?
Fred
The flood of relief that broke over her felt almost shameful, following so precipitately on the news Will had told her this morning. But there was no help for it. She put the letter into her tunic pocket, and hurried out to catch a tram north to Islington. On the way she kept taking out the little note to read again. By the time her house was in sight she was struggling to control herself, a messenger ready to combust from the volatile mixture of gratitude and grief roiling within her.
She had been up so late in anxious consultation with her mother that she decided to stay over at Thornhill Crescent. It had been many months since she had slept in her old bedroom, and the sudden strangeness of being back there did not make for a restful night. The next morning had begun bright and warm, but as she was stepping off the tram at the bottom of Gray’s Inn Road she noticed the sky had darkened. She walked west through Lincoln’s Inn Fields and thence towards Endell Street, by which time a heavy battalion of dark clouds was massing across the horizon. With a few minutes to spare before her rounds, she decided to stop at St Teresa’s and ask Will the favour which she and her mother had tentatively discussed the previous night. Mrs Callaway was to visit their Beaumont cousins in East Molesey today with the news about Louis; it was Connie’s idea that she might prevail on Will, once he was well enough, to accompany her on another visit there. It might comfort Mima and the girls, she thought, to hear of Louis’s last moments of bravery from a friend and fellow officer.
The orderlies were serving breakfast as she arrived on the ward. Will, who was not sitting up in bed, had declined even a cup of tea.
‘Not hungry this morning?’ she asked. He only shook his head. She looked at him more closely, and realised that he was drawing shallow, rapid breaths. ‘How are you feeling?’
‘Not too good,’ he admitted. She sat down by him, and checked his pulse. It was somewhat fast and small; the heartbeat was increased, too. She investigated the bullet wound, thinking it might have become infected, but behind the pad of gauze the perforated skin looked clean. She saw that he winced when she put a hand, quite gently, on his chest.
‘You do seem to be feeling a bit of pain,’ she said in a reasonable voice.
‘Actually, this is the worst I’ve felt since I arrived here.’
‘Well … I’m going to ask one of the surgeons to have a look at you.’
A shadow of alarm passed over his face, which she thought uncharacteristic. As she stood up she gave him her most reassuring smile. ‘Someone will be down to see you. Don’t worry.’
She went in search of Dr Muir, but was told that she was already in surgery. The senior surgeons were also occupied. She had just managed to locate Dr Tisdall, another surgeon, and was explaining Will’s symptoms when two loud rings of the bell echoed up from the square. Another convoy of wounded had arrived. In a breezy, almost cheerful tone, Dr Tisdall said, ‘No rest for the wicked! I’ll look in on your patient once we’ve got this lot out of the way.’
For the next two hours, Connie was busy sorting out critical cases that required immediate treatment from those less severely wounded who could be left to the ministrations of the VADs. She had never got used to the sight of nineteen- and twenty-year-old youths who bore the haunted, haggard aspect of old men, some blank with shell shock, some with faces blistered from gas. There was only one fainter among the volunteers that morning, when the white shin bone of an amputee’s leg became rawly exposed on a stretcher; Connie was more jolted by the sudden slap of the girl’s face as it met the floor.
Once the rush had thinned out, she retraced her steps to the officers’ ward to check again on Will. What she now saw gave her serious alarm. He was awake, but he was gasping for his breath. Asphyxia threatened. The colour of his skin had changed to a bluish grey, and his pulse had become rapid. There was also a kind of bulging of his chest, which she knew indicated either a traumatic pleurisy or else a secondary haemorrhage. Yet what baffled her, when she felt his skin, was the apparent absence of a pleural infection – pale and clammy as he looked, Will wasn’t sweating or shivering. Whatever was wrong, she had to get him to a surgeon as quickly as she could. She looked into his eyes, which were dulled and yellowish, and said, ‘Will – I’m going to take you to surgery.’ He gave no sign of having heard. She hailed a passing nurse, Nell Thomas, a genial and conscientious Camden girl whom she had known since her days at the Hotel Claridge.
‘Nurse, this man’s in pain. We have to get him upstairs, at the double.’
Nell peered over at Will, and gave a little grimace. ‘’E doesn’t look so clever, does ’e? I’ll go and get a trolley.’
As they emerged from the lift into the surgical ward, Connie’s heart sank at the vista of trolleys lining the long corridor, a traffic jam of wounded men all awaiting attention; the chaos in the receiving room had been subdued, but up here it was still rush hour. In such a place there was no avoiding it, that smell, acrid and urgent with fear: the smell of mortality. The men had been brought here, without ceremony, to say goodbye to something, a limb, a damaged organ – maybe to life itself. It was a lonely place to make that farewell, but then dying always was lonely.
She looked down at Will, whose breath came now in ragged heaves, and offered a silent, desperate prayer that he might be spared. Nell, taking in the frantic disorder around them, helped wheel him into the anaesthetic room, then went off in search of a surgeon. While she was gone, Connie had another look at Will’s painfully distended chest, and felt his heart, now slightly displaced – could it be a haemothorax? She had once seen Cluett at St Thomas’s deal with complications from a stab wound to the chest; he had somehow opened the pleural cavity and drained it. She remembered now the dark, bloodstained, uncoagulable fluid that issued from the cut. At that moment Nell returned to the room, shaking her head. ‘There’s not one of ’em free, Sister. Every theatre’s being used. He’ll just have to wait –’
‘What? He can’t wait’ she cried. ‘His heart’s about to go into arrest –’
Nell, working her teeth nervously over her lip, glanced at the patient. ‘’E might hang on … you never know.’
But Connie did know: the bulging veins in his neck and the bluish colour around his lips told her. She percussed his chest, and felt the hyper-resonance. They had a matter of minutes in which to act. She said, in a commanding voice she barely recognised as her own, ‘Prepare a tray.’
Nell flinched with surprise. ‘What for –’
‘Please, Nell. He’s dying.’ She walked over to the sink and began scrubbing her hands. Behind her she heard Nell, after a momentary hesitation, walk across the room to fetch the chloroform canister and the mask.
‘Leave that,’ said Connie. ‘We haven’t time to put him under.’
She sensed her own movements operating from an automatic agency independent of her will: she seemed almost to be watching herself pull on the apron, gloves and mask, dunk the instruments in the steriliser, paint the brown iodine square on the patient’s chest. She became aware of the seconds ticking by, narrowing the possibility of rescue. She checked the non-return valve of a syringe, then connected it via a steel-nozzled rubber tube to a hollow needle. At the last moment she discarded the small scalpel and, drawing a breath as a diver might before a plunge, she thrust the needle, dagger-like, into the upper chest wall. (‘Ohmygod,’ she heard Nell mutter.) Had she gone deep enough to reach the pleura? She hoped she had. Behind her a door had opened and someone entered, but Connie didn’t look round. Nothing less than the ceiling falling in would have disturbed her concentration. Will was making a low groaning sound, though he seemed unaware of the violent penetration of his chest. She held the syringe steady and waited. This would be the moment of truth. She pressed her thumb slowly upon the piston, and listened. Moments passed, as long as hours;
then there came, quite audibly, a thin whistle of air from the needle, like a football being punctured. Connie raised her eyes to Nell, standing opposite; a beat passed between them before Nell said, in a small uncertain voice, ‘Is that meant to happen?’
19
BY THE NEXT morning Connie perceived herself to be an object of behind-the-hand whispering. In the hospital corridors she could sense a hesitancy in the nurses and VADs as they passed her, as though they were savouring the thrill of an outlaw among them. The story of her unauthorised emergency surgery on one of the officers had gained an instant purchase on the gossip market. At first nobody could quite believe that Sister Callaway had had the temerity to perform such an operation, single-handedly, still less that her intervention had actually saved the patient’s life. At the hearing, hastily convened the previous night, the WHC committee had listened calmly to the matron’s deposition of the offender – ‘a gross and unconscionable breach of hospital discipline’ – before inviting Connie to answer personally for her unwarranted behaviour.
The hospital commandant and the chief surgeon presided over the committee, which numbered six in total. Their first aim was to establish why Connie had seen fit to take matters into her own hands. She explained that she had not done so lightly, indeed would have preferred not to; but the patient’s condition was critical, all the surgeons were otherwise occupied, and she felt quite convinced that immediate action was the only way to save his life.
‘What convinced you that he was in mortal danger?’ someone asked.
Connie replied by enumerating the patient’s symptoms. ‘Taken together, it seemed very likely to me that he was suffering a tension pneumothorax. As you know, if not treated within minutes it will cause cardiac arrest, and death.’
From the bemused glances Connie saw passing between some committee members it was clear that not all of them did know. The euphoria she had felt on completing the operation that morning had slowly dissipated during the day, and now she felt only a weariness. The commandant, a steely-eyed, long-faced woman in her forties, cleared her throat.
‘Sister Callaway, I gather that the patient on whom you operated today was a man already known to you. Did this have a bearing on your decision to act?’
‘It may have done – but if it had been a patient unknown to me I think I’d have done the same. I was intending to talk to William – Captain Maitland – when I arrived this morning … that was the only reason I became aware of his respiratory difficulties.’
The commandant nodded at this. ‘Dr Muir has told us that you regularly attend her during surgery – is that why you deemed yourself qualified to perform this operation?’
‘I didn’t consider myself qualified,’ Connie replied. ‘I don’t. There was very little time for me to calculate the chances of his survival. It may sound odd to hear it, but I found myself operating on the patient before I’d really decided to do anything.’
‘And yet Matron claims that it is not untypical for you to “put yourself forward” and interfere in hospital business beyond your remit.’
Connie glanced at the matron, purse-lipped and righteous, and determinedly not looking in her direction. ‘I’m sorry that Matron thinks that way. I have only ever tried to be helpful to her.’ The commandant dipped her head to listen to something her chief surgeon had to say. After a few moments she turned to Connie and asked her to wait outside.
In the gloom of the corridor she paced quietly, and thought about the frowning expressions she had just left behind. Through an open window the smell of lime blossom wafted, and she stared out into the soft night shadows. She lit a delinquent cigarette, and stood smoking with her arms crossed, left hand cradling her right elbow. It was hard to know exactly what punishment the committee would consider appropriate to her ‘offence’. Would they suspend her? Dismiss her from the Corps altogether? It would be harsh in the light of what had happened. She had hoped that women in a position of influence might prove themselves fundamentally different – might acknowledge an instinctive allegiance among their sex instead of cleaving to the old forms of hierarchy. But then perhaps women, given the chance, would exercise their authority just as ruthlessly as men; indeed, men had shown them the way. No matter. She had taken a risk, and it had paid off. Will was still in the world because of her.
The door opened, and a nurse invited her back into the room. The hospital commandant asked Connie to be seated.
‘I’d prefer to stand,’ she replied. The commandant looked up from the notes in front of her, and inclined her head as if to say, ‘As you wish.’
‘Sister Callaway – I don’t think I have to impress upon you the gravity of this case. In twenty-five years of working in hospitals I have never encountered so singular a breach of protocol as the one before us today. Without consulting any of your superiors, you took it upon yourself not only to make a diagnosis of a patient but to perform an instant surgical procedure for which you were wholly unqualified. The fact that the patient was personally known to you is not an excuse – indeed, a professional surgeon when faced with such a conflict would most likely have passed on the responsibility to a colleague. It should perhaps not surprise us that these considerations failed to trouble you. You are not a professional surgeon. So I comprehend the outrage of those such as the matron’ – at this she glanced at Connie’s glowering accuser – ‘who would have you dismissed from our staff. One might be tempted to take that step on grounds of simple expediency: it would be impossible to run a hospital with a proper degree of competence and safety if a junior nurse suddenly decided she would like to play surgeon for the day. We have a duty of care to our patients, and we cannot afford to expose them to the whims of meddling amateurs.’
Connie felt herself flinch at that disobliging epithet. The commandant had paused; when she continued, her words were directed at the assembled. ‘There is another side to this case, however. In the last week the hospital has been obliged to take in unprecedented numbers of wounded men from France. It has meant that at times we have been overrun, never more so than this morning. Having ascertained the dangerous condition of her patient, Sister Callaway acted with great decisiveness in taking him directly to surgery. On finding no surgeon available for consultation, she herself took the matter in hand – and, as we now know, her diagnosis and treatment were blameless. The patient’s life was saved. For this, she deserves our warmest commendation. While her action may offend the spirit of medical orthodoxy, it surely behoves an institution such as ours to defend capability, and to promote initiative. At the very least we ought to admire her courage. Your reputation, Sister Callaway, is cleared – one might say it is enhanced.’
No sound could have astonished Connie more than the spontaneous burst of applause that immediately followed these words.
Will had been sleeping when she visited his bedside on her rounds, and knowing that he was to have a visitor later she kept clear of the officers’ ward for the rest of the morning. Nell, herself now a magnet of interest once her supporting role in the emergency-room ‘incident’ became known, called in at the staffroom just before lunchtime with a message.
‘There’s a couple of lady visitors in St Teresa’s who’ve asked to see you, Sister. The older one’s proper hoity-toity,’ she added with a sardonic laugh.
‘I think that will be Captain Maitland’s mother,’ she said. Connie guessed she had brought Eleanor with her.
‘They’re at his bedside, if you want to go.’
She was just leaving the room when she turned back to the nurse. ‘I’m glad you were there yesterday, Nell. I told them what a help you’d been.’
Nell gave her a wry look. ‘I don’t mind tellin’ you, Sister, I was that petrified in there I ’ardly knew what I was doin’.’
Connie offered her own smile in return. ‘Well, then – that makes two of us.’
The bracingly imperious figure of Mrs Maitland she recognised as soon as she entered the officers’ ward. The younger woman she took a few moments lo
nger to place: not Eleanor, it seemed, but Ada, Will’s fiancée. A huge vase of crimson roses glowed on his bedside table. Neither visitor noticed her approach, but Will did. Propped up on pillows, he looked quite ashen-faced, and frailer, since his brush with mortality; he raised his hand effortfully in greeting, alerting the women to her entrance.
‘Ah, Sister Callaway – Sylvia Maitland,’ said Will’s mother, rising from the chair to shake hands. She fixed Connie with a neutral look that suggested she had no memory of the girl who had provoked her displeasure at luncheon four years ago. ‘This is Miss Ada Brink, William’s affianced.’ Connie tipped her head in greeting, bemused by Mrs Maitland’s determined conspiracy that they were meeting for the first time. There was the briefest pause before she continued. ‘I gather we are indebted to you, Sister. Dr Muir said that your intervention in surgery yesterday was most – opportune …’
‘It was – a matter of luck,’ said Connie, with a modest shrug. ‘I’m just relieved that he’s out of danger.’ She had her eyes on him as she spoke, and read in his expression a mutual understanding that this was a scene they would rather have played between themselves. Ada, in a striped voile dress, put a gloved hand to Will’s forehead and murmured, ‘We are all relieved. Now we must get you home and look after you properly.’
A silence followed, and Connie, adopting a polite tone, said, ‘I wonder – how is Eleanor?’ The enquiry prompted a noticeable flinch in Mrs Maitland, who now seemed bound (as Connie had intended) to acknowledge their previous acquaintance. But she recovered herself quickly, and replied that Eleanor was also working as a VAD ‘somewhere in south London’. There was the faintest edge in her voice to suggest that this was not an occupation she would have wished for her daughter. The news rather cheered Connie, though she said only, ‘Please do pass on my regards.’ Mrs Maitland responded with a brusque twitch of her mouth, as if it were rather beneath her to be passing on Connie’s or anyone else’s regards.
Half of the Human Race Page 38
