by Tony Pollard
But there was nothing to be gained from trying to avoid the inevitable, and so I set out to confront Sir Benjamin directly. I refused to be a fugitive in my own hospital and could only hope that he remained unaware of my temporary absence – the man, after all, had many responsibilities.
I was just about to leave my office when William appeared carrying a cylindrical parcel. ‘It just arrived,’ he announced, filling the room with the fumes from last night’s brandy. Placing it on my desk and standing back, he watched as I cut the string and lifted the lid. Beneath a layer of crumpled paper sat a brand-new top hat of unmistakable quality. The brushed felt shimmered as I lifted it free. A note shoved into the silk hat-band read:
A replacement for your loss while being of such valuable service. I hope it fits. Yours, I. K. Brunel
I held it by the brim and placed it gingerly on my head. It slid perfectly into place, coming to rest just above my ears. ‘Very nice,’ William observed. ‘A man needs a hat.’
Brunel’s fine gift was much appreciated and would require a note of thanks, but first I needed to speak to Sir Benjamin. Hearing no response on knocking at his office door, I walked on a little further up the corridor, entered the anteroom next door and asked his assistant about the superintendent’s whereabouts. Even Sir Benjamin seemed to have little regard for Mumrill, an unpleasant weasel of a man who would rather see a patient suffer than shift a farthing from one column of his account book to the next.
He squinted at me from behind his desk, spectacles perched on the end of his sharply whittled nose. ‘Sir Benjamin is showing some important visitors around the hospital. A note was sent to all senior members of staff yesterday. Didn’t you receive yours?’ Then he added with barely disguised relish, ‘Oh, of course you wouldn’t have, would you? Sir Benjamin was most disappointed when you didn’t arrive for your appointment.’ All this was just the build-up to the news I did not want to hear: ‘He was somewhat perturbed, to say the least, when he discovered you had left the hospital.’
‘No, that’s right. I had to attend an emergency,’ I said, by way of explanation, the words souring in my mouth. I resented offering any excuse to the man, but needs must. I told him I hoped to see Sir Benjamin later in the day and asked if, in the meantime, he would be good enough to pass on my apologies for any inconvenience caused. As I left the office he crowed, ‘I’m sure Sir Benjamin will be delighted to see you later.’
When later came, I was working with William on some modifications to the operating table. The thing was ancient and really nothing more than a heavy wooden bench, which would not have been out of place in one of Brunel’s workshops. The coarsely grained surface had accumulated a veneer from years of use and despite being scrubbed down by William after every operation had turned like ebony after soaking up so much blood and visceral fluid. As we laboured together, it struck me that William was almost a product of these same processes, for a web of blood vessels covered his drinker’s cheeks like the fire-cracked glaze on an antique pot; his grey teeth and yellow, straggling hair completed the picture of a man coloured by too many hard years.
As a porter William may have been less than ideal, but on this occasion I had chosen to focus my dissatisfactions on the table. I had made several requests for a replacement, but all of these had been turned down by Sir Benjamin, no doubt after seeking advice from Mumrill and his blasted ledger. I would not have minded so much if it were used only for dissecting the dead but more often than not it was occupied by a living patient. A cadaver is all well and good for getting across the principles of anatomy, but when teaching practical surgical skills there is no substitute for students witnessing a real operation.
I was sawing away at the tabletop beneath me, standing astride it. William was leaning back against the table taking a well-earned breather after his turn. Our aim was to cut a hole for a blood bucket in the table rather than simply allowing the fluid to run off in all directions, if not over me then on to the floor to be soaked up by the carpet of sawdust. I was tired of having to wade through the stuff, and more than once had narrowly avoided slipping on my backside – amusing for the students perhaps, but not so funny when I had a scalpel in my hand. Our theory was sound but the practice a different matter. The tabletop was half an inch thick and very heavy going, especially so due to a hard knot located on the very circumference of the partially cut hole. I was beginning to regret ever starting the job and was busy cursing both the wood and the saw.
‘A bad workman always blames his tools,’ said William.
‘Thank you for that pearl of wisdom,’ I gasped between draws on the saw. ‘You needn’t sound so smug, William – it’s almost your turn again.’
‘Ah well, the good news is that we’re not going to want for sawdust for a while.’ He was right: impressive piles of the stuff were accumulating beneath the table.
Making one last burst of effort, I looked between my legs to see an upside-down Sir Benjamin reversing into the room, pushing the double doors open with his back. The guided tour which Mumrill had mentioned was obviously in full swing, as he was delivering a spirited commentary. ‘And here we have the operating theatre, where we also teach anatomy and introduce the basics of surgical technique.’ He was accompanied by a man and a woman, both of whom were brought up short by the sight of a man standing astride a dissecting table attacking it with a saw. Only when he became aware that his audience’s attention was fixed on something other than his speech did Sir Benjamin turn around.
Despite my obvious inabilities as a carpenter, the companionship of labour had served to lift my spirits, and my trepidation about the confrontation with my superior had almost entirely evaporated. ‘Good afternoon, Sir Benjamin,’ I offered, raising the saw in salutation. William, however, rightly guessed that this was no time to be seen idling and made himself scarce.
Sir Benjamin looked to be having some difficulty comprehending the scene he’d walked in on. ‘Dr Phillips, may I ask what on earth you are doing up there?’
I hopped down on to the floor and brushed sawdust from my clothes as I approached them. ‘Just a few modifications, Sir Benjamin. This table, as you know, is quite antediluvian in design so I thought I’d bring it into the nineteenth century. Nothing major, you understand, just the odd tweak here and there.’
After having momentarily forgotten his responsibilities to our visitors, Sir Benjamin turned back to them. ‘This industrious gentleman is Dr Phillips, our senior surgeon. We are very proud of his progressive approach to surgical technique. And as you can see, there is no end to his talents.’
The woman was the first to speak up. ‘I don’t think I have ever seen an operation actually carried out on an operating table before.’
‘Dr Phillips,’ Sir Benjamin continued, ‘it gives me great pleasure to introduce Miss Florence Nightingale, whose reputation obviously goes before her; also her colleague, Dr Sutherland.’
As had been the case with my introduction to Brunel in this same place I was vaguely familiar with the woman’s appearance, her likeness having regularly appeared in the newspapers during her celebrated service in the Crimea. She must have been in her late thirties but still retained the handsome looks suggested by her portraits. The raven-black hair was hidden beneath her bonnet, but this also served to frame the attractive curves of her face and long neck.
‘Miss Nightingale is here on behalf of the Royal Sanitary Commission,’ explained Sir Benjamin, ‘and will be carrying out a study of methods and practice as part of the commission’s review of civil and military hospitals.’
‘In truth, my report to the commission has already been submitted,’ added Miss Nightingale, ‘but I am keen to further my study of civil hospitals in the hope of coming up with some suggestions about improved organization and design.’
Sir Benjamin sniffed at this correction but carried on regardless. ‘I must take this opportunity to congratulate Dr Phillips on his actions of yesterday. I am informed that, thanks to his intervention after an acciden
t at Millwall docks, the lives of several men were saved.’
I saw his game immediately. He was nervous about having somebody of such high repute, and a woman to boot, examining the workings of the hospital and so was keen to cast his domain in the best possible light.
‘Really,’ said Miss Nightingale, breaking away from the group to take a closer look at the table.
‘Does the hospital have an ambulance service?’ enquired a rather bored-looking Dr Sutherland.
‘Yes, we do have a limited facility,’ I said, and looking to Sir Benjamin, ‘but we are hoping to expand the service.’ In reality, however, the issue had never been on the hospital board’s agenda, nor was it likely to appear there in the near future.
‘What caused the accident, Dr Phillips?’ asked Miss Nightingale. ‘The malfunction of a piece of equipment during the failed launch of Mr Brunel’s ship. I am afraid Sir Benjamin exaggerates my abilities. I was unable to save one of the men.’
‘A shame, but I am sure you did all you could. Do you think, doctor, that such tragedies are the price we have to pay for progress?’
‘That may be so, Miss Nightingale, but I doubt very much whether they figure on the bill when it comes to accounting for the costs.’
The celebrated nurse looked at me thoughtfully while running a delicate hand around the edge of the cut in the tabletop. ‘I am sure you are right, doctor. But you are obviously not beyond making improvements yourself, and this old table is truly in need of them.’
‘It’s for a blood bucket.’ I said, referring to my handiwork.
‘But am I right in thinking you intended to trace a circle rather than create something that looks like a jagged scar?’ She looked up to see me frown, and immediately deflected it with a smile. ‘I am sorry, Dr Phillips, I am teasing you, a terrible habit of mine.’ She picked the saw from the table. ‘I am sure you are much more accustomed to using such tools against flesh and bone rather than wood.’
‘That is very true,’ I admitted. ‘Carpentry, as I have learned today, is not my forte.’
Sir Benjamin, no doubt feeling the two of us had monopolized the conversation for long enough, offered a third voice. ‘My own feelings on amputation are well known, Miss Nightingale.’
‘Oh,’ she said. ‘And what are they, Sir Benjamin?’
The superintendent bristled. ‘Why, that in many cases, it should not be carried out if at all possible. We underestimate the body’s powers of recovery and tend to use amputation as a first recourse rather than the last.’
‘Most laudable, but the decision to amputate a limb must surely be taken on a case-by-case basis. In the Crimea the sanitary conditions were so bad that delaying amputation was akin to signing the wounded man’s death warrant. Even a few hours’ delay could give infection a foothold. Far better to apply the saw as soon as possible; only then can infection be kept at bay.’
‘I cannot speak for the Crimea, Miss Nightingale, but here in a London hospital, where levels of sanitation are much higher, I have demonstrated the worth of sparing the saw.’
‘I am sure you have, Sir Benjamin, and I look forward to discussing the matter with you in more depth, but now I think it is about time for lunch, don’t you?’
‘Of course,’ Sir Benjamin responded, only too happy to have the party move on to their next destination.
Miss Nightingale withdrew to the door held open by Sir Benjamin. ‘Good day, Dr Phillips. I look forward to our next meeting.’
‘And good day to you, Miss Nightingale. I hope that next time you find me engaged in more medical pursuits.’
The visitors departed, their host herding them from the rear. But then, just when I thought the coast was clear, Sir Benjamin stepped back into the theatre. ‘No more hiding behind a woman’s skirts, Dr Phillips, you and I have unfinished business. Kindly report to my office at three o’clock.’
Left alone to ponder my fate, I too decided that it was time for lunch. Munching my way through an apple and a piece of cheese, I found some distraction in the editorial of The Times, which reported on the events of the previous day.
London, Wednesday, 4 November 1857
The consummate engineer must possess not only grandeur of ideas but accuracy of execution. His eye must be microscopic as well as telescopic, and as fitted to inspect a mite as to comprehend the heavens. The higher his aspirations and the more daring his plans, the firmer grasp must he have of every detail, and the surer must be his footfall at every step. If there is nothing too great for him to adventure, it is because there is nothing too little for him to care for. The case of the monster ship of which the launch was attempted yesterday at Millwall is a proof of this. The greatest and most wonderful of modern constructions is complete, and only waits for fit machinery to move it from the place where for four years it has been the admiration of the world. Yet, until cables and drums and brakes are made to do their work, it must remain stranded and unable to realize the fond hopes of its builders.
In this country we are in the midst of the movement. The most memorable scientific enterprises of late years have been the Britannia Bridge, the Submarine Telegraph, the Crystal palaces of Hyde Park and Sydenham, the Atlantic Telegraph, and the wonderful ship which was for the first time moved yesterday. All these have been carried out here, and we have learned from them to interest ourselves deeply in the progress of important works.
The Cunard line and the Collins line were content if they alternately outdid their rivals by 20 feet of length or an extra half-knot in the hour of pace. But the new ship disdained comparison. Her principle was new, she would be propelled by a union of powers never before joined, she would enter the water in a new manner, she would necessitate a new system of business to sail her at a profit, she might even be expected to call new towns into existence on the shores of harbours sufficient to shelter her.
There then followed a list of impressive dimensions which, given my first-hand experience of the vessel, I could not be bothered reacquainting myself with. The closing paragraph went on to describe the sorry events of the day before, and it came as no surprise that the article did not see fit to mention that a man had lost his life in the attempt.
‘Take a seat, Dr Phillips,’ said Sir Benjamin, without looking up from the notes he was writing. I settled nervously into the chair opposite him, taking time to glance around the well-filled bookshelves covering the walls of the office. After a suitably uncomfortable period of silence he looked up. ‘I had hoped to see you in that chair yesterday, but then I learned you were busy saving lives in Millwall. You will, no doubt, be pleased to know I received a note from Mr Brunel this morning praising your actions.’
‘That was good of him,’ I replied, while wishing he had limited his praise to sending me the hat. ‘But as I said earlier, my role in the affair has been exaggerated.’
‘That may be true, but there is one attribute of your method we cannot overlook, as it will revolutionize medical practice.’
‘I’m afraid I don’t follow,’ I said, unable to work out from which direction the blow was coming.
‘I refer of course to your ability to forecast accidents before they happen, which allows you to be there on the scene when they do. I would be as sceptical as the next man about this uncanny talent if I didn’t know for a fact that you left the hospital yesterday at eleven o’clock in the morning having reported to the duty man that you were going to attend an emergency, which, wonder of wonders, did not occur until around one o’clock in the afternoon. Incredible, is it not?’
I squirmed in the chair while Sir Benjamin surveyed the effects of his well-aimed sucker punch. His intelligence, no doubt provided by that snake in the grass Mumrill, was spot on. He had me over a barrel and there seemed little point in trying to make excuses. ‘Yes, my departure from the hospital was rash, and I apologize for that. However, I cannot regret the incidental outcome of my actions. There can be little doubt that more men would have died in the absence of a doctor. Which, as fate would have it,
happened to be me.’
‘I am glad you are able to take comfort from that thought, Dr Phillips. I can only hope you can continue to do so after I have had your employment with the hospital terminated for gross dereliction of duty.’
‘Once again, I can only offer my apologies and ask you not to take that course of action. I can assure you this will not happen again.’
‘Quite right it won’t happen again. You have spent far too much time over the past weeks in Mr Brunel’s company. This is not the first occasion he has distracted you from your work.’
‘I’m afraid that I have to argue that point, Sir Benjamin. I have never before let my conversations with Mr Brunel interrupt my duties. Yesterday was an exception.’
‘That’s not what my sources tell me, but never mind.’ Mumrill had been at work again. ‘Listen to me, Phillips. You are a first-rate surgeon and I would regret having to let you go.’ He picked up his pen and wagged it aggressively. ‘But I swear, if anything like this happens again, you’ll be out on your ear. Do we understand one another?’
‘Yes, Sir Benjamin, we understand one another.’
‘Very well then, we will let the matter of yesterday’s lapse in your judgement drop, but consider this a stern warning.’
‘I will, sir.’
I stood to take my leave, but Sir Benjamin wasn’t yet finished with me. ‘One other thing,’ he said, already having begun to write again.
‘What is that, Sir Benjamin?’
‘That infernal woman, Miss Nightingale,’ he rasped without looking up.
‘Oh?’
