The Nurse Novel

by Alice Brennan

  When he finally stood with the rest of the operating team over Graham’s draped and painted chest, which was all that was visible of his friend now, he resolutely put all personal feelings aside. Elwood Browne became simply a pair of sterile gloved hands assisting him as he removed the third and fourth left costal cartilages to enter the pericardial cavity. And Daisy Andrews was merely the means by which the right instruments were slapped into his hand at the precise moment they were needed.

  Draining the cavity which contained an increased quantity of clear, slightly yellow fluid, David found a bulge where something was embedded in the myocardium, or heart muscle, at the left ventricle.

  “That could be our tumor,” David said.

  “Or maybe not,” Browne snapped. “Let’s try aspirating before you cut into it.”

  David found the aspirating needle in his hand, and introduced it carefully, but nothing could be sucked out.

  “We’ll have to cut and ligate this artery before I can excise anything,” David said, noting that a branch of the coronary was embedded in the fat at the base of the mass. As soon as Browne had completed the ligation David began dissecting sharply to separate the excess tissue from the heart muscle, careful not to tear through the myocardium into the cavity of the heart.

  “Are you going to be much longer?” the anesthetist asked.

  “I don’t know yet. What’s his condition?”

  “Pressure’s been dropping—but not radically. If it won’t be too much longer…”

  “Here it is!” David exclaimed. To save time, he had cut into the lesion before completing the dissection, and there was the tumor. The wall was tough and calcified. Opening it, he found a thick, cheesy substance.

  “That’s why it made an indistinct shadow,” he said, “and didn’t fill with diodrast. I’ll have to curette and wash it out before dissecting the wall from the myocardium.”

  “Pressure’s dropping faster now,” the anesthetist warned.

  “I’ve got to finish this!” David groaned. “Miss Andrews, prepare an intravenous drip of Noradrenaline, four milligrams per thousand milliliters of five percent glucose.”

  “There isn’t any time!” the anesthetist protested. “Pressure’s falling too fast—he’ll go into heart failure.”

  “All right then, Andrews,” David snapped, realizing that Graham could die while she was setting up the intravenous flow. “First bring me a five cc Coramine injection—twenty-five percent solution.”

  She was fast, but even so, before she handed him the prepared syringe, he was having to massage the heart to keep it beating. He couldn’t complete his surgery while the heart was being massaged, but if the Coramine would keep it stimulated until the Noradrenaline drip could take over and bring up the blood pressure…

  He rammed the needle into the myocardium and pushed the plunger.

  The effect was instantaneous—but not what he had expected. Graham went into a violent convulsion, making further surgery momentarily impossible.

  “What the devil did you give me?” David cried, whirling to Andrews, finding her staring at him with mouth and eyes wide open.

  “You—Did you say twenty-five percent?” she quavered, grabbing the box of ampoules from the tray and staring at it horrified. “You’d just given the Noradrenaline order… I must have got confused…”

  “You mean you gave me Noradrenaline?” he snapped, his mind quickly checking on reactions and antidotes.

  “No! It was Coramine—but the wrong solution—it was too strong—it…” Her voice gurgled off as she stared at the writhing body being held forcibly on the operating table.

  “Oxygen!” David shouted at the anesthetist. “And phenobarb!”

  “Here’s the phenobarb,” Matthews said, plunging a needle into Graham’s arm. He must have got it from one of the other nurses, David thought, for Andrews seemed to have disappeared.

  As the convulsions quieted, David went on with his dissecting, working as swiftly as possible, but with great care.

  Graham’s heart was still beating when he had finished and they could close the wound.

  It was only then that someone asked worriedly about Miss Andrews.

  “It isn’t like her to walk off the job,” Matthews said. “Even after a mistake like that.”

  “I’ve heard her claim she never made a mistake,” David said, “so how does anyone know how she’d act?”

  They had turned their sutured patient over to the anesthetist and jerked off their sweaty masks before anyone left surgery. Matthews was the first to open the door into the scrub room.

  “Here she is!” he exclaimed, and the startled tone of voice brought them all to the door. His voice was low and tremulous as he added, “This is how she acts when she has made a mistake.”

  She was on the floor, her body distorted as if it had writhed in convulsions before it went rigid in death. A hypodermic syringe, probably the same one he’d used to inject Coramine into Graham’s heart, David thought, stood upright on her chest where she had accurately gauged the exact intercostal space to plunge the long needle and inject a lethal dose straight into her heart. There were broken Coramine ampoules on the floor beside her.

  Matthews knelt and took gentle hold of her wrist. “It’s too late for antidotes now. She must have done this immediately after the mistake was discovered. If we hadn’t been so busy bringing Graham out of his convulsion, we’d have heard hers. I’ll send word to Pathology—they’ll take care of her until the coroner comes.”

  * * * *

  As they dressed in the doctors’ room, glum and shaken, they could talk of nothing else.

  “She must have made a fetish of infallibility,” Matthews said thoughtfully. “Her ward was always run like a machine, and she brought the same efficiency to surgery. To her, any mistake was inexcusable. Someone should have told her that even machines can go haywire.”

  “I doubt if anyone could have told her anything,” David said, remembering the woman’s arrogance last night. Well, she was no longer a threat to Janet’s career, or his own, but he couldn’t be happy about it ending like this.

  “I know what you mean,” Matthews said, smiling sadly. “Daisy wouldn’t listen. She wanted to do the telling. For doctors and nurses, a mistake can be such disaster that we’re inclined to harbor an inordinate fear of them. We try to put on infallibility like a white jacket, but it doesn’t fit, because we’re still human. The shock of finding that out can bring disastrous results. It caused Daisy to kill herself.” He looked directly at David. “It lost you a malpractice suit.”

  David heard the sharp intake of breath where Elwood Browne stood beside him, but he didn’t glance at the man. He met Dr. Matthews’ intent gaze.

  “So you knew about that too,” he said wearily.

  “Of course.” Matthews sounded quite casual. “I couldn’t recommend a surgeon to the post I’m vacating without thoroughly investigating his background. I’m satisfied that you would never have lost that suit—it wouldn’t even have been filed against you—if you hadn’t been overwhelmed by the thought that you had made a mistake. It was an honest mistake. You should have maintained that the best doctor in the world, faced by the same symptoms, would have drawn the same conclusion.”

  He was right, David realized with the insight that sometimes follows incredible blindness. He had been too apologetic to the man’s wife. He had reacted to her censure by blaming himself—and she had taken advantage of that.

  “Each time you’ve taken a stand here,” Matthews went on quietly, “you’ve turned out to be right. But you may not always be correct in your diagnosis—no one is. Do you think you could admit to a mistake now, without losing your equilibrium, or worse?”

  David drew a long thoughtful breath before he answered.

  “I honestly believe I could, now,” he said at last. “I think I’ve been maturing profe
ssionally ever since I arrived here to work in Cyril Claibourne’s clinic. I’ve learned that doctors can disagree without any of them being actually wrong. It usually turns out that we just haven’t followed our findings far enough.”

  “I understand Claibourne is going to offer you full membership in his clinic. Are you going to accept?”

  “I certainly am! I believe a group of doctors might come closer to infallibility than one alone, though not even a group can actually claim it.”

  David was still thinking of that as he walked down the corridor. He seemed to have lost his old dream of building a great reputation through a practice of his own. The anonymity of clinic practice no longer bothered him for through it his work had become more important than ever, and that was what counted. Working with other doctors made it simply more stimulating and fruitful.

  He needn’t be alone in his personal life either, he realized, finding that his feet had automatically carried him to the door of Janet’s room.

  The empty bed was made up neatly, and for a moment he was staggered by a tremendous sense of loss. Then he saw her at the window, wearing a sheath dress of beige wool, matched by a turban of the same material.

  “I was afraid you’d gone,” he said, his voice sounding strangely thick and shaken. The blankness of that bed where he’d expected her to be sitting up to greet him, had somehow unnerved him. For he knew now that if she had been gone, he would have had to follow.

  “I had to wait for you to sign my release,” she said, her voice light and casual in contrast to the poignancy of his own emotions. She offered her hands, which he took in both of his, knowing he never wanted to let her go.

  “Janet, I’ve got to tell you…”

  “About Andrews? I’ve already heard. News travels fast in a hospital, you know. It—it makes me feel sick, somehow. That’s why I want to go home for a while. You say I can’t go on duty yet, but surely I don’t need a hospital bed! I’d like to go home and persuade my father to drop the charges against Arnold Crane. Maybe Arnold’s been scared enough to learn his lesson. And after all, I did do a damn fool thing that day giving him his bed bath. I broke a rule of nursing that was made for a nurse’s protection. I learned a lesson too, and now I’d like to put the whole thing behind me. So will you sign my release? Then I’ll ask Mrs. Burns for leave.”

  He was gazing at her intently, her words making less impression on him than the appeal of the lips that uttered them.

  “You weren’t listening!” she accused him. “David, I don’t believe you heard a word I said!”

  “It doesn’t matter.” His voice was husky. He moved his hands gently up her arms to take a firm hold of her shoulders and drew her close. “I only came in to tell you I love you. I want you to marry me.”

  “Oh David!” she cried, her breath like a sob as she snuggled close. “I was afraid you were never going to say that!”

  Working in his clinic office a week later, he rang for his next patient and was surprised when Coralee was ushered into his consultation room.

  “This seemed to be the only way I could get to see you,” she said apologetically, “you’re so busy all the time. David, how is Graham? Is he getting along all right?”

  “Just fine. His operation was a complete success. In a month or so he’ll be good as new.”

  “How long before it will be safe for him to know that I—I can’t go on with our marriage?”

  He felt his mouth tighten angrily. “So you’re going to start that again. I thought you were trying to…”

  “David, it’s just not right! We don’t belong together, we never did, and the sooner a mistake is corrected, the better all around. Pretending to love is—Well, he knows it’s phony as well as I do. It’s time we both admitted it. I simply can’t go on being his wife.”

  Her eyes implored him tearfully. He set his jaw. “You must know by now I’m engaged to marry Janet.”

  “I know. But that doesn’t change the fact that my marriage is a horrible mistake. I’m all packed up ready to leave, but I just can’t tell him, David! Please tell him for me!”

  He shook his head. “That’s not my place. If you can’t tell him yourself, there’s only one other person who should do it. So suppose you tell her.”

  “You mean Mildred.” She swallowed hard. “That would be pretty humiliating.”

  “No more than you deserve. And it would give her a chance to set things straight. She has known Graham for a long time; she understands him better than anyone. I think she’s the one to handle it, if you won’t do it yourself.”

  * * * *

  He didn’t see Graham until the next day. He went into his hospital room then, half expecting to see his friend crushed and broken. But he was no such thing.

  “Come in, David, and don’t look so concerned,” he said, with a brave show of heartiness. “I suppose you’ve heard that Coralee left me flat, but I’m not going to let it get me down.”

  “That’s good,” David said cautiously. “Personally, I think you’ll be better off. She’s a beautiful girl, but she hasn’t the strength of character you deserve in a wife.”

  “Don’t gloss it over. I know I was an old fool, and I don’t deserve half the good luck I’m having.”

  His eyes suddenly filled with tears which he blinked away sheepishly. “Believe it or not, David, Mildred is going to take me back. We’ll be remarried as soon as the divorce goes through. No man is fine enough to deserve a woman like her, and I’m never going to forget it again!”

  “I’m sure you won’t!” David said fervently. “And I’m awfully happy for you, Graham. For Mildred, too.”

  Graham sighed and smiled tremulously. “It’ll be like a miracle, going back to the old life, with the kids coming to see us between semesters and all that… All this other business will slip into the past like a nightmare. I made an awful mistake, but Mildred’s so damn sweet about it. It’s wonderful when we get a second chance.”

  “I know,” David said gently, remembering that it was through this friend he’d got his own second chance. And this time he was making good.

  NAVY NURSE, by Rosie M. Banks

  CHAPTER 1

  Alice Smith—a plain name for a vibrant girl—was sitting in an overstuffed chair in a club in midtown Manhattan. It was not her club really—she had one of her own, the Officers’ Club at St. Albans, the Navy Hospital in Long Island, where she was a Navy nurse. The club, a civilian one, had extended its courtesies to members of the armed forces during World War II, as had most clubs in New York, but unlike them had not withdrawn the privileges at war’s end. Officers were still welcome and were granted a so-called limited membership; that is, they had to be okayed by an admissions committee (nobody had ever been blackballed) and they were supposed to pay cash, not sign, for their meals and drinks. It was a gracious gesture, but also practical, since the club, like all others the world over, was always perilously close to the red.

  It was six-thirty of a summer evening and Alice was trim and pretty in her seersuckers. She had received a message from Patricia—her roommate, whom she had been awaiting—that she could not meet her because of an emergency at the big civilian hospital uptown where she and Pat had trained and met. Pat had stayed on there after they passed their state boards and Alice went on to the Navy, but their friendship remained firm and they shared a small apartment on East Seventy-ninth Street that had a view of the East River.

  When Alice got Patricia’s message, she picked up a magazine and sat down in the big comfortable chair to kill an hour before going home and cooking herself some dinner. She was a good cook, upstate New York country style. Perhaps she might see a friend—she had not yet made too many, but the number was increasing. The magazine was open on her lap, but she was not reading it, and although her eyes were open she was dreaming. With her elbow she knocked her gloves off the arm of the chair, but she did not even notice. She
was dreaming…

  * * * *

  Alice Smith had been born in Alexanderville, a small upstate New York town, of a well-to-do farmer and an invalid mother. Her dark beauty was so—somehow—subtle that even her father, Hiram, had committed the unforgivable sin of stating in her presence that she was plain. It had shaken her confidence, and her mother, chronically ill, had been unable to do anything to mend it. Alice had been shy, not very popular—possibly because she was too bright for most of her companions and certainly because she simply didn’t know how to engage in the everlasting small talk with which they beguiled their hours.

  She had not been happy in Alexanderville and it is also likely that the care she had to give to her mother turned her thoughts to becoming a professional nurse. When she spied a Navy nurse recruiting poster in the window of Green’s drugstore one day, she felt her fate had been determined.

  Hiram Smith approved when she declared her intention: he felt that the happiness of his daughter lay elsewhere than in Alexanderville. He was a strange man, bitter, resentful that his wife was an invalid and that his daughter was not a son, yet he was capable of tenderness and understanding. He gave Alice his blessing, and off to New York she went.

  Three years it had taken—three wonderful, short years. She remembered clearly the spring day when she had applied to the School of Nursing at the giant hospital in uptown Manhattan. She had stood in the park looking at the mammoth buildings and had felt tiny and scared. The buildings were the story of the hospital, its growth and progress, told in terms of architecture.

  The original building, loosely modeled after the Pitti Palace in Florence, was the farthest downtown, looking outmoded now and used chiefly for administrative purposes. The hospital, like the city, had moved uptown and northward, and each new building was by so many years more modern and efficient than the one adjoining it to the south until the parade culminated in the breath-taking glass-and-aluminum Apdorpf Pavilion, the very latest word in hospital design. But right next to these was her building—the fifteen-story School of Nursing, where, if she was good enough, she would live and learn.