Now why, I thought, and then I thought of Paul Streeter and his imminent arrival from the theatre. I took another look at his voluminous notes, which took my mind off everything else.
Chapter Thirteen
GOD BLESS ALL BLOOD DONORS
Paul Streeter was twenty-eight and worked in a London bank. He shared a flat with two other men and they had already rung to ask after him. His parents had emigrated to Canada five years ago and his named next-of-kin was his only and married sister. She lived in Durham, the Office had rung her, and she was coming to London as soon as her mother-in-law arrived to look after her two children.
A girl called Audrey East rang. ‘I’m no relation, I’m not his wife, we’re not engaged, but I happen to love him. I must know ‒ how is he?’
I told her as much as that allowed me.
‘He’s still having his operation? Will they let me see him? I’ll come anytime ‒ I‘ll wait all night!’
‘I’m sorry, Miss East, but he won’t be allowed any visitors tonight.’ I left out the ‘unauthorised’. ‘It’s the anaesthetic. It takes a long time to wear off and he’ll need to be kept very quiet until it does.’
‘I didn’t know that. Nurse’ ‒ she hesitated ‒ ‘this operation. Will it cure him? Or isn’t that a fair question?’
‘It’s fair, but I’m afraid not one that anyone could answer yet.’
‘I suppose not. Can I ring up again tonight?’
‘Of course. As often as you like.’
‘Can I really? Nurse, thanks.’ Her voice shook. ‘It’s so funny. When I first met him eighteen months ago, he’d never been ill at all. Then he started having this indigestion and the doctor sent him to St Martha’s, and since then he’s been in and out. I’ve wished they’d operated before. My father had a gastric ulcer for years and then they took out half his stomach and he’s been wonderful ever since. Why’ve they waited so long with Paul?’
She was neither his wife nor next-of-kin. I had to say, ‘I’m afraid that’s another question I can’t answer.’
Luckily, she put that down to ignorance. ‘You’re not a doctor. They’ll know. Perhaps they’ll tell me. You tell him I’ve rung? Give him my love. All my love.’
I felt like Judas Iscariot. The ulcer was the lesser of Paul Streeter’s two ailments. The forty pages of his medical history file were mainly concerned with his blood disease, and all but today’s were signed by Joel. So I checked his door was still shut when the bed came back.
The Resident Anaesthetist came with it. He was holding high the vacolitre of blood running into the unconscious man’s splintered left arm. Hills on the other side was holding the bottle of saline dripping into a vein in Paul Streeter’s right ankle. He had heavy flaxen hair and a very good bone-structure. He looked like one of those medieval portraits of dead saints in stained-glass windows and the scarlet streak of the nasal tube strapped to his face added rather than detracted to that impression. He was one of the very few patients I had ever seen to look in life the colour of death.
Mr Brown arrived in theatre clothes a few minutes later. ‘Well, Bert?’
The R.A. unhooked his stethoscope from his ears. ‘Still with us. That’s about all.’
‘That’s something.’ Mr Brown laid a hand on Paul Streeter’s forehead, took his pulse, frowned at the two sets of apparatus, then caught my eye and walked off. I followed him. He said, ‘This is what I’ve done and want done ‒’
He was still talking when the R.A. joined us. He stopped. ‘What do you think now, Bert?’
‘That it’ll be a bloody miracle if he lasts until morning as he’s hardly an uncollapsed vein left, and if that blood stops God only knows how we’ll get it going again. Without the blood he hasn’t a hope in hell.’
‘That’s what I like about gas-men,’ observed Mr Brown, ‘always so bloody optimistic.’ He took off his green cap and scratched his damp hair. ‘I hope the poor bugger does. Didn’t like having to stick a knife into him. Had to agree with Rowlands, either I went in or he’d bleed to death internally without any bloody delay. The mess!’ He made a wide circle of his thumb and forefinger. ‘That size.’
I said, ‘I’ve read his notes, Mr Brown, but I still don’t understand this blood problem. He’s not a haemophiliac ‒’
‘No. This is one of the new problems much exercising the minds of our erudite physicians. Being only a ruddy technician with a knife, all I know is poor bugger’s clotting time’s bad enough to send me to an early grave. You’ll have to take up his medical condition with Dr Rowlands.’ He looked down his neat nose. ‘You’ll have heard we’re co-operating?’
‘Yes, Mr Brown. Is there anything you wish me to tell him when he comes in?’
‘All in my op notes. I presume he can read?’
‘Yes, Mr Brown.’
‘Then I’d better get my clothes off. Oh ‒ Kirby awake?’
‘Entertaining Miss Brecklehurst and Dr Shaw.’
‘That’ll save my varicose veins as I want to see them as well. Don’t bother, Staff. I’ll look after myself.’
I looked after him briefly. Joel might well want to hear all. I still didn’t think it a good idea. Of course, I had actually been there when we had to pick him off the floor four nights back.
Paul Streeter’s bed was set at such an angle that he looked to be standing on his head. Neither that nor the pints of blood he had already had were yet making the slightest impression on his waxy pallor. His pulse-rate was appalling and very hard to find. He was on a quarter-hourly pulse, respiration and blood-pressure check, and an as near non-stop as possible transfusion watch.
The Night Super rang up. ‘I’ve not one nurse to spare as special or even to relieve your meals, Staff. I’ll have trays sent up. You can manage?’
There was only one answer. ‘Yes, Sister. Thank you.’
I told Hills and added, ‘You’ll have to settle Dr Kirby for me.’
‘Oh, Staff! I know he’s being much nicer than I thought, but must I?’
‘You must, love.’ We were in Paul’s room. ‘Here’s our illest, but we’ve other ill patients and I’m not allowed to wear roller-skates. Wait here whilst I get Dr K’s sedative. He’s written up for them and tonight he’s having his caps whether he wants ’em or not! The traffic coming and going into this room’ll keep him awake on its own.’ I made for the drug cupboard so fast I heard my skirts rustle. Though we had been so much busier lately I hadn’t heard that particular sound or moved at that speed since my training. I took Joel’s bed-ticket off the desk, the Dangerous Drug Book, bottle of capsules, a teaspoon, saucer, and medicine tray, and showed the collection to Hills. ‘Check his script. Right? Two. Good. And stand there whilst he swallows ’em.’
‘Staff, what if he refuses?’
‘He won’t if you tell him I’ve told you to give him them. He might play up a senior. Not a junior. He’s not the type.’
‘I just hope you’re right.’
A few minutes later she came back to sign the book and tell me I was. ‘He said he didn’t want ’em but he’d better have ’em or you’d create to us both. He was rather sweet.’
‘Good. Wait again whilst I lock this stuff away.’ In doing so I noticed Nanny flashing like a juke-box. ‘Hills, find out what William main want. If it’s me, come back here and I’ll go along.’
Between us we managed to watch Paul constantly and settle the others. Inevitably it took double the usual time, but by eleven they were all quiet.
William Small Ward Two was quiet, but the men in long and short white coats came, went, and came again with the regularity of the drops of blood falling through the glass drip-connection set in the long thin transfusion tube. Partly as Paul Streeter was an old patient returned, partly as he was of our generation and very probably dying, we all used his Christian name. That couldn’t help him, but it helped us. It is never easy to watch the young die, and particularly not when alone amongst strangers. By unspoken and universal consent, we made him our chum.
Dr Shaw was on night call for the Wing In-Patients Lab. He came hourly to measure Paul’s clotting time. The junior surgical registrar came three times. Mr Brown, four. Dr Rowlands escorted by Brendan Cousins, four. Once he asked, ‘Paul left or right-handed, Cousins?’
‘Left. They’d to use it in the theatre after his right and left leg veins packed up. They’d a hard job on hand!’
Dr Rowlands looked wooden. ‘It’d be highly improper for me to comment on my surgical colleague’s technique.’
Brendan stood just behind his boss. He picked up an invisible axe with both hands and sliced the air.
I looked round. ‘Here’s Mr Brown again, Doctor.’
Brendan caught my eye and crossed himself. Our seniors gave each other icy nods and in the small ward stood on either side of the tilted bed and looked down in a silence that would have been stifling had it not been so haunted. Neither man was far off Paul Streeter’s age. Hospital senior staff acquire a certain immunity to infections and, sometimes, to emotions, but seldom to the there-but-for-the-Grace-of-God syndrome.
‘Poor bugger,’ murmured Mr Brown.
‘Yes,’ agreed Dr Rowlands.
Before they left, both said, ‘Keep that blood running, Staff, and ring me, stat, in my room if it stops.’
Audrey East rang again just before the Night Super arrived for her very late first round. ‘He’s still unconscious? Is that bad.’
My chest was tight. ‘He’s had a big operation, Miss East. He’s bound to be unconscious a long time. I’m sorry.’
The Night Super watched me ring off. She was a thin middle-aged woman with the grey complexion of the habitual night worker. She had very calm blue eyes that could still be saddened but no longer shocked. ‘The girl-friend, again? Poor child.’ She looked at the latest clotting time. ‘He’s not yet had enough to alter his balance. Which pint is he now on?’
‘The seventh, Sister. You’ve heard we’ve now got the Manchester blood?’
‘Yes. Dear me. Well. Let’s see him …’
Our meals had arrived and were waiting in the pantry. It was nearly two before all the rounds were over and we were quiet enough for Hills to take her tray into Sister’s day office. I put a chair in Paul’s doorway and wrote my 2 a.m. report on my lap, whilst watching both Paul and Nanny. Previously I had regarded that latter as a handy invention. I had now altered that to godsend.
All the Wing wards were sound-proofed against each other. Hills had shut herself in the day office and the silence of the danger hours seemed to shut me off into a strange sleeping world in which only I was awake. Only ‒? And I found I was holding my breath and listening.
I had known a good many sensible, efficient, and far from imaginative nurses who, under oath, would have had to admit they could smell Death. Not the smell of an open carcinoma, gangrene, or any other condition that can lead to death, but Death itself. I had known other nurses as convinced they had seen Death, and again, not in the faces of the dying, but Death, hovering in the middle of a ward or passing the foot of a bed.
It had been around the start of my third year that I began to realise all this was not just another old-nurse’s-tale but an established if inexplicable fact of hospital life. Certainly it was another fact that my hearing was unusually acute. And one early afternoon during the patients’ rest-hour in Victoria, I had been sitting at the middle table with the senior staff nurse, the ward had been silent and we had both been writing, when I looked up so suddenly that she asked, ‘Someone coming in our flat?’
No one had come in. The patients were all sleeping. Not one that afternoon was on the D.I.L. I said, ‘Sorry, Staff, hearing things,’ and we went on writing. Until ten minutes later a woman sat up, gasped ‘Nurse!’ and died of a pulmonary thrombosis before we reached her corner bed.
The staff nurse had been a large, phlegmatic north-country girl. Afterwards, she said, ‘You heard Death passing by, Dexter.’
I hadn’t accepted that then. But when much the same happened again in a different ward and hour, and then again, I learnt to accept without understanding. I might have found that more difficult, had I not worked in a hospital. Blind acceptance comes more easily after one has seen one’s first few patients officially condemned as moribund by learned and conscientious specialists walk out and back to years of healthy life. Acceptance comes rather less than easily when one’s confronted with a child dying of a malignant disease, but even then full understanding has to remain suspended. The most brilliant physician may as brilliantly answer the ‘What caused this child’s death, Doctor?’ In every hospital ward in every hospital in the world, the ‘Why, Doctor?’ continues unanswerable.
I looked across at Nanny. Knowing nothing of electronics, I couldn’t begin to understand how that machine actually worked. I just knew how to use it. As I now knew I knew how to use my ears.
Or was I just using my instincts? Or letting rip an over-vivid imagination? Miss Nightingale would have called it fanciful womanish nonsense. What would she have called Nanny? Or the first Elizabethans, radio, if one had attempted to describe it and managed to finish the job before being burnt as a witch?
My hand wrote: ‘Mr Lane. William Main. Bed Four.’
I looked up at the drip-connection. Drip. Drip. Drip. Scarlet velvet blobs against the white transfusion stand. I wondered if the unknown donors ever fully realised what they were doing when they ambled up to hand over a pint they wouldn’t miss. As a junior I did a couple of weeks in our Donor Unit. ‘Well,’ they said, ‘doesn’t hurt me and may do some good.’
My ears were working on their own. That chirrup was Mr Cox in William main sucking his teeth. That irregular little grunt, Mrs Sleeman in Mary main. That sigh and creak of springs, Mrs Bridger turning over in Mary Two. She was a heavy woman. If she had woken, the springs would creak again when she reached for her watch or a drink. The springs stayed silent. Mr Worstley broke the silence with a snorting snore. Then very close there was the double click of a light on and off.
Joel’s was the only small ward door properly shut. The others were ajar with mufflers round the handles to save banging. Only Mr Worstley’s and Joel’s fanlights were black. The rest reflected the dim crimson of the nightlights.
Hills came up from the day office. ‘Going to have yours now, Staff?’
‘I’ll have to finish this report first.’ I tilted my head. Joel behind that closed door was shifting too carefully to be asleep. I pointed at his door. ‘Awake.’
‘Want me to ask if he wants anything? He’ll only say, “No, thanks.” He always does.’ She was quite good at looking a hard-done-by junior. She did a great job on that now. ‘If I must, I must.’
‘I’ll go.’ I put my writing things on the floor. ‘You take over here. If Nanny goes berserk, put your head round the door. If you think that blood’s stopping, open the controls like I showed you earlier and then buzz the M.M. on his bell.’
The M.M. stood for Martha’s MAYDAY. One short, one long, one short buzz on the nearest bell. It was only used interstaff and then very seldom. Being so seldom used, its use affected all staff within hearing like a high-voltage electric shock.
Hills didn’t have to use it during the few minutes I spent behind the closed door in Joel’s room. He was wide awake. He looked nearly as ill as on his first night, but far from euphoric. He jerked a thumb at the connecting wall. ‘How’s he doing?’
‘Hanging on. All the blood’s come.’
‘That’s a break.’ He seemed about to sit up, then lay back. ‘I’ve only just woken. I’ll be off soon. I don’t want anything, thanks.’
Wally Brown was his great friend. I had thought Wally Brown used the wrong therapy earlier. Yet had I only known Joel as Mr Brown’s patient, such a thought would never have crossed my mind. I had worked with Wally Brown long enough to trust as well as respect his professional judgement. If he was right, I was wrong. Joel’s present appearance was even more wrong. To accept his reply at face value would just be excusable for a junior;
any night nurse from the third year upward who could take it as that was in the wrong business.
I leant both hands on his footrail. ‘You may not, but as you’re awake, I do.’
That sat him up. ‘What?’
‘I want you to stick your neck out again. Off the record.’
He smiled slightly. ‘Let’s have it.’
‘You know Paul Streeter better than anyone else. So if he stops, is there any one of the approved techniques for getting it moving that works better with him than the others? I’ve read your notes till I know ’em by heart. I couldn’t find a pointer. I asked Brendan Cousins. He said he didn’t think anything worked and once Paul stops, he stops. I said how did you keep him going on those eleven pints? He said sure to God, Mrs H, he only wished he’d the same talent for the tricks of the trade as himself as then maybe they’d make him the next S.M.R., W.’
He flushed. ‘Thanks.’
‘Joel,’ I said sharply, ‘I’m not making pretty speeches for fun. I want some help. Is there an answer?’
‘Give me time, girl. If you want me to think fast, don’t plug me with barbiturates. Let me think. For a start ‒ which tricks have you in mind?’
I ran through all I knew. ‘Anything I’ve left out?’
‘Only one. Praying.’
‘Like that?’
‘Yes.’ He locked his hands behind his head. ‘With Paul, as with all the dodgy clotters, the only way I’ve found to keep ’em going is to watch ’em like a lynx and act fast when they even look like slowing slightly. That, you’re doing.’
‘Yes. Hills or me. And if you know that, you haven’t had much sleep. Or any?’
‘So what of it? I can sleep all day tomorrow.’
‘How’d you take that if you saw it in the night report on one of your patients?’
‘Hoisting me with my own petard?’
‘Just reminding you that I’m a night nurse and in S.M.H., London, the first duty of every night nurse is to ensure her patients sleep.’ He was watching me oddly, but he was looking much less wretched. ‘Joel, I realise tonight is being hell for you. I wish there was something I could do about the fundamental problem, but there isn’t. We both know it, so I’m not going to irritate you by pretending there is. I will stick my own neck out and say I’m as sorry you’re not on your two feet tonight as you are. And that’s no reflection on either Dr Rowlands or Mr Brown. I’d trust ’em both with my life. They may be at each other’s throats tonight, but neither could have been better with the lad next door. Only they don’t know him as you do ‒ and I don’t know Dr Rowlands as I know you.’
The Healing Time Page 15
