The Nurse Novel

by Alice Brennan

  “She had only your welfare at heart. She’s worried about you, Janet, and so am I. Please…” He took the forceps from her fingers to lay aside. Her hand was shaking, so he captured it in his and drew her close with an arm about her slender shoulders. “Let’s go over and see Graham right now.”

  A harsh sound, which was becoming all too familiar, brought him around sharply to face the door. Miss Andrews was standing there, her face once again tight and hostile.

  “Well, Dr. Sterling,” she said caustically, “if I don’t find you with one woman in your arms, it’s another. This time you’re trespassing in my territory. Miss Raleigh is supposed to be on duty.”

  Janet had already wriggled from his grasp. She walked over to Miss Andrews and said in a shaky voice, “I’m going off duty right now. I’ll go straight to Mrs. Burns’ office and ask her to send someone to take my place.”

  She brushed past the woman and walked on out, her head high. David started to follow, then paused to stare down into Miss Andrews’ grim, disapproving countenance.

  He could think of a dozen cutting remarks he’d like to make, but none would cut her down as devastatingly as she deserved. Rather than spouting something that would make him sound childish and ineffectual, he satisfied himself with matching her venomous gaze for a long, tense, and bitter moment, then stalked out.

  By the time he was admitted to Mildred’s office, Janet had gone.

  “She asked for a few days off to go home and sort of pull herself together,” Mildred explained. “It sounded like a good idea so I granted a week’s leave. When she gets back, Andrews will be in surgery.”

  “What if something develops from that head injury?”

  “She promised to see their doctor right away. She’ll be in good hands, David. She comes from a fine family, with plenty of money.”

  “So I’ve heard. Where is she now? At the Nurses’ Home? I’d better go say good-bye.”

  “No—you’d better not. I’m afraid it was a mistake to tell you about last night’s escapade. Having you know seemed to be the crowning humiliation. By the time she comes back next week, maybe you’ll both be a little surer of how you feel about things.”

  He stood in uneasy silence for a moment, then shrugged and smiled. “I’ll take your advice, though I have a feeling I shouldn’t. If I hadn’t been so damn chicken about committing myself, I would never have let her make that date in the first place.”

  * * * *

  Janet sat wearily at the table, watching a floor show without seeing it, sipping a cocktail she didn’t really want.

  So why am I drinking it? she asked herself derisively.

  She glanced at her watch. Five minutes after midnight. If she’d remained at the hospital she would just be going off duty, and not half so tired as she felt right now.

  The house burst into applause as the floor show ended, lights came on, and the band struck up a dance number.

  “This is our dance,” Allan Hargrove said, taking her hand as the other couple left their table and moved onto the small square of dancing space.

  She stood by obediently and nestled in his arms to follow as expertly as he led her through the intricate steps they had learned together long ago.

  “Having a good time?” he asked, smiling down at her.

  She nodded. No use telling him how bored she had been all this week. He’d done his very best to make it a gala week for her.

  Everyone had. She had phoned her mother before making the brief trip home by bus, and both parents had been at the station to meet her.

  “If you’d called earlier I’d have driven up after you,” her mother had said, hugging her tight.

  Her father hugged her too. “We’ve been begging you to come home for a week-end,” he’d said, laughing, “and here you suddenly turn up for a whole week!”

  “Not quite!” she had corrected quickly. “I’ll have to go back Sunday afternoon. I’m not sure what shift I’ll be on Monday.”

  “You sure you don’t want to stay for good?” he’d asked. “Aren’t you tired of nursing yet?”

  “No—just tired. I’ll be rested in a day or two.”

  She hadn’t told them about the bump on her head. They’d have insisted on her going through some big clinic for tests, and she’d have felt silly. Her headache was practically gone now, and the lump had subsided to negligible size. She wanted to forget the whole affair.

  She’d had one full day of rest before anyone else knew she was home. Since then she’d hardly had a minute to herself. There’d been a hastily arranged party of her friends to welcome her, and dates with Allan every night.

  “Do you really have to go back tomorrow?” Allan murmured in her ear, drawing her a little closer as they danced.

  “Of course I have to!” she declared firmly. “I was lucky to be granted this much leave.”

  “It’s been a wonderful week, Jan, and it could go on like this if you’d just get over your crazy idea of wanting to be a nurse.”

  “It’s not a crazy idea! I am a nurse, and I love it!”

  “Well, if you had to train, why didn’t you pick a hospital here in the city? So I could see you more often.”

  “You’ve been answering that all this week—you and the rest of my friends. I can’t take nurses’ training and keep up my old social life at the same time. It’s easier to be out of reach than to keep saying no.”

  He gave her a last whirl and stopped at their table, facing her seriously as they sat down.

  “Jan, honey, I don’t like the way you lump me with the rest of your friends. I used to think I had a special place in your life. I thought after you got this nursing bug out of your system, we were going to get married and settle down. But lately you haven’t even answered my letters. And when I can’t reach you by phone, and leave a message for you to call back, you seldom do. What’s the matter? Is there someone else?”

  She returned his gaze gravely.

  “Answer me!” he said, his voice sharp as she hesitated. “Is there someone else?”

  “I think there is, Allan. I’m not sure how he feels about me yet. But I know that he’s the man I want.”

  His face was bleak for a moment before he managed a grin. “Then I hope you get him, Jan,” he said softly. “You deserve the best. I hoped you were going to be for me—but if you’re not, I guess I’d better start looking around for second best.”

  Chapter 15

  David sat at his desk beside the spacious window of his private office and watched Graham Burns cross the street from the hospital.

  Seven weeks, he thought, marveling. Seven weeks since Graham’s collapse on the golf course, and not another symptom had developed. Unless you could call that slow, tired gait a symptom. But Graham insisted that he felt fine. And any man his age might be chronically weary with a wife like Coralee.

  Graham stopped at the curb and looked as if he were panting. Shortness of breath? Was the man suffering symptoms he wouldn’t admit?

  There were three steps from the street sidewalk to the walk leading to the clinic door. Graham took two of the steps, then paused, his hand pressing suddenly to the left side of his chest. It dropped just as abruptly, and he glanced around furtively, as if afraid he might have been observed. He took the last step and walked sturdily until he was too close to the entrance to be in David’s view.

  David opened his private door and intercepted him in the hall. “Have you got a minute, Graham? I’d like to talk to you.”

  Graham smiled and turned in. “I have two minutes if you want them. Haven’t you any patients?”

  “I just sent my last patient to the hospital—and I’m about to go over there myself. But I was watching you come up the steps, Graham.”

  “Snooper!” Graham made a wry face.

  “You grabbed your left side as if you had pain.”

 
“Hell, no! Not pain, doctor. Just a slight feeling of constriction now and then. It doesn’t amount to anything.”

  “You’re still short of breath, after just walking over from the hospital. How about letting me listen to your heart?”

  Graham grinned. “Help yourself, doctor.”

  There was still an occasional extrasystole, but no cardiac murmurs. David took his blood pressure and found it one-thirty over eighty.

  “Let’s do another electrocardiogram,” he said.

  “And then what?” Graham scoffed. “You’ll want more diodrast studies to mull over that shadow again. Don’t you get tiled of chasing shadows, doctor? I’m all right, David. I ought to know.”

  He stood up and patted David’s shoulder. “Sorry I can’t accommodate you, and I’ve enjoyed this little consultation, but I have patients waiting.”

  Before checking on his hospital patients, David went to Radiology and once again studied the roentgenograms of Graham’s heart. Diodrast had been injected into a vein at the left elbow, giving a clear picture of the innominate vein, the vena cava, and the pulmonary artery. There was definitely something. Possibly a tumor that didn’t communicate with any of the cardiac chambers. There also seemed to be some calcification of the heart wall. He wished Graham was willing to let him operate. But as long as Matthews and Browne and Claibourne didn’t agree to the necessity…

  He returned the films and went up to Third West where he knew Janet was on duty, and doing fine now that Andrew was out of her hair.

  She was standing behind her chair at the desk, staring with an expression of horror at her left hand, which she was gripping with her right hand.

  “What on earth’s the matter?” he demanded in alarm.

  She gazed up at him, bewildered. “It keeps getting numb,” she said. “It’ll be all right in a minute, but it keeps going to sleep.”

  “How long has this been going on?” he asked, taking her left hand in both of his to massage it gently.

  “I—I don’t know. At first I thought I must have been lying on it, or something. But now it goes numb right while I’m using it, sometimes all the way up my arm. And today my left leg did the same thing.”

  “Do you have a headache?” he asked sharply.

  “Well, yes, but not bad. I’ve been feeling as if I’m coming down with the flu or something. Could that make my hand numb?”

  “No. Where does your head ache?”

  She laid her hand above her right temple. “Not where I got bumped, if that’s what you have in mind. Besides, that was at least six weeks ago!”

  He nodded. “Has anything else been bothering you? Do you stagger when you walk? Bump into things?”

  She flashed him an amused grin. “You think I’ve been drinking?” Then she sobered abruptly. “I almost forgot—I did bump the door going through it this morning. And one other thing—I tried to type a letter last night on my portable, and it came out looking like a foreign language. The fingers of my left hand kept getting on the wrong keys without my knowing it. I finally had to give up.”

  He dropped her hand and turned to the phone. “We’ll get someone to take your place here. You’re going straight to bed for a complete neurological examination!”

  “Oh, David, don’t be silly!”

  “Listen to me, Janet. Six weeks ago you had a severe blow at the left of the base of your skull. Now you’re having a headache at the opposite pole—the front right region. That, plus your central nervous symptoms, is just about a classic picture of subdural hematoma. It’s imperative to have it diagnosed promptly and aggressively, for if that’s what it proves to be, the sooner we get you to surgery, the better.”

  She had grown pale as he spoke, and her eyes seemed enormous. “What—what exactly is subdural hematoma?” she asked shakily. “It sounds like a blood tumor under the dura mater. That’s the membrane covering the brain, isn’t it?”

  “Yes, and put simply, you’ve got the right idea. You see, when your head crashed against a rock…” He laid his hand at the remembered spot. “Right here?”

  “Yes, but that isn’t where my head aches now.”

  “I know. Think of a—well, a box of loose eggs, let’s say. Hit the box at one end, and the force of the blow might break the eggs at the other end. Just so, your head injury could be at the opposite pole.”

  “Why didn’t I feel it there right away?”

  “The injury wasn’t severe enough to cause massive bleeding. Just a tiny slow leak that formed a small clot in the subdural space which, as you probably learned in your anatomy, is between the dura mater and the arachnoid, two of the membranes covering the brain.”

  “Yes, I know.” She felt her head gingerly, her eyes still wide and wondering.

  “In the weeks since the clot was formed,” he went on, “it may have been absorbing fluid, by a process similar to osmosis, and in the protective way the body has of behaving, it covered the bloated clot with new tissue, or neoplasm, to wall it off. So, in effect, it has become a tumor. Get the picture?”

  “Yes, but I don’t like it. What do you have to do?”

  “First, Graham will have to make sure I’m right. This is just my snap diagnosis, you understand. He’s the neurologist and will do a painstaking job of medical detection to establish the exact nature and location of your trouble. If I’m right, the only thing to do is a craniotomy—open your head and remove the clot.”

  She shuddered.

  “Don’t be afraid, honey. Burns is an expert.”

  “I know.” She smiled tremulously. “I can’t help being afraid—but I’ll let him do whatever is necessary.”

  “Good girl. And Janet, we should notify your parents.”

  “No, please, not yet! No use worrying them until—Maybe this will all turn out to be nothing.”

  “Maybe,” he conceded dryly, turning to the phone. “But don’t bank on it.”

  Late that night Janet lay flat on her back in a hospital bed, feeling tears scald her eyes.

  For the past week she had been trying to bury her fright and ignore the strange symptoms. Now Dr. Burns was trying to confirm her worst fears, and she’d end up having brain surgery. What if it left her an idiot? Or paralyzed?

  Her first test had been an electroencephalogram. A neurological nurse had settled her on a couch in a small cubicle of a room, then fastened a number of tiny, needle-sharp clamps in her scalp, and read the graph made on a machine across the narrow room. The nurse wouldn’t give a report, but Dr. Burns had told her later that some abnormality had been indicated.

  He had also run a pencil up the sole of her foot, telling her he was looking for a Babinski sign, but not saying whether or not he found it. He’d done a spinal puncture without mentioning any results on that either.

  He had pricked her arm lightly with a needle, from hand to shoulder, asking her to specify where the point felt sharpest. And he had questioned her minutely about her fall, how long she may have been unconscious; and about her present symptoms, just when each had started. Finally, he had given her a pencil and paper telling her to write the whole thing out in precise detail.

  Does he think I can’t tell it the same way twice? she wondered, recalling his repetitious questions. Is my mind affected already, and I don’t know it? She’d always understood that a mental patient seldom recognizes his own insanity.

  When David peeked through the door, she wiped her eyes hurriedly and told him to come in.

  “I hoped you might be asleep by now,” he said softly. “How do you feel?”

  “Ignorant! Dr. Burns hardly tells me a thing! What has he found out?”

  “Nothing conclusive. He’ll make more tests tomorrow. Meanwhile, I really think we should notify your parents.”

  “Not yet! If they think I might be facing brain surgery they’ll be scared to death. Wait until you’re sure!”


  “You’ll have to go to surgery tomorrow for the tests, Janet. Graham wants to do a pneumoencephalogram first.”

  She drew a sharp breath. “That’s putting air in the brain, isn’t it? Through the spinal column?”

  “Yes, it’ll be like the spinal puncture. You didn’t mind that, did you? You won’t be anesthetized at first, except for some pre-op drugs to make you very sleepy and un-caring. You’ll have to cooperate by sitting up with your legs drawn over the edge of the table so the air, when introduced, will go up to your brain. After X-rays of that you’ll be put completely under for some arteriograms.”

  “Radiopaque substance in the arteries?” she asked, remembering her classroom studies.

  “That’s right. It will be injected into a carotid artery in your neck, to dye the circulatory system of the cranium and show just what the situation is there.”

  “With I have a terrific headache afterwards?”

  “You may, for a while. And you might have a sore neck for a day or two. But Burns is clever and careful. He won’t hurt you any more than he can help. And of course, you won’t know anything about it at the time. Now, don’t worry.” He bent and kissed her on the lips, a light, comforting kiss such as a mother might bestow on a hurt or anxious child.

  He was gone before she could quite catch her breath. She set her mouth grimly.

  If I live long enough, David Sterling, she said behind her clenched teeth, you’re going to kiss me again—but not like that!

  * * * *

  David stood beside Graham and Dr. Browne, studying the row of arteriograms that hung wet and dripping from the developer. Janet had been wheeled to the recovery room, not yet awake after being put under for the films to be made.

  A sensation of pressure built up under his ribs, sending a wave of dizziness to his head as he realized the significance of the thick, dark shadow breaking up the neat pattern of blood vessels on one side of the cranium.

  “Looks like massive subdural hematoma,” Dr. Browne declared confidently. “I’d say there’s no time to lose.”

  “There certainly isn’t,” Graham agreed. “We’d better bring her back from the recovery room before she wakes up, and keep her under for immediate surgery. Where are the girl’s parents? We’ll want their signed consent.”