by Ngaio Marsh
“Really?”
The nurse came back.
“Sir John would like to see you for a moment, Lady O’Callaghan.”
“Thank you. I’ll come.”
Left alone with her brother, Ruth dabbed at his hand. He opened his eyes.
“Oh, God, Ruth,” he said. “I’m in such pain.”
“Just hold on for one moment, Derry. I’ll make it better.”
She had found the little package. There was a tumbler of water by the bedside.
In a few minutes Phillips came back with the nurse.
“Sir John is going to make an examination,” said Nurse Graham quietly to Ruth. “If you wouldn’t mind joining Lady O’Callaghan for a moment.”
“I shan’t keep you long,” said Phillips and opened the door.
Ruth, with a distracted and guilty look at her brother, gathered herself up and blundered out of the room.
O’Callaghan had relapsed into unconsciousness.
Nurse Graham uncovered the abdomen and Phillips with his long inquisitive fingers pressed it there — and there — and there. His eyes were closed and his brain seemed to be in his hands.
“That will do,” he said suddenly. “It looks like peritonitis. He’s in a bad way. I’ve warned them we may need the theatre.” The nurse covered the patient and in answer to a nod from Phillips fetched the two women. As soon as they came in, Phillips turned to Lady O’Callaghan but did not look at her. “The operation should be performed immediately,” he said. “Will you allow me to try to get hold of Somerset Black?”
“But you, Sir John, won’t you do it yourself?”
Phillips walked over to the window and stared out.
“You wish me to operate?” he said at last.
“Of course I do. I know that sometimes surgeons dislike operating on their friends but unless you feel— I do hope — I beg you to do it.”
“Very well.”
He returned to the patient.
“Nurse,” he said, “tell them to get Dr. Thoms. He’s in the hospital and has been warned that an operation may be necessary. Ring up Dr. Grey and arrange for the anæsthetic — I’ll operate as soon as they are ready. Now, Lady O’Callaghan, if you don’t mind leaving the patient, nurse will show you where you can wait.”
The nurse opened the door and the others moved away from the bed. At the threshold they were arrested by a kind of stifled cry. They turned and looked back to the bed. Derek O’Callaghan had opened his eyes and was staring as if hypnotised at Phillips.
“Don’t— ” he said. “Don’t — let— ”
His lips moved convulsively. A curious whining sound came from them. For a moment or two he struggled for speech and then suddenly his head fell back. “Come along, Lady O’Callaghan,” said the nurse gently. “He doesn’t know what he is saying, you know.”
In the anteroom of the theatre two nurses and a sister prepared for the operation.
“Now you mustn’t forget,” said Sister Marigold, who was also the matron of the hospital, “that Sir John likes his instruments left on the tray. He does not like them handed to him.”
She covered a tray of instruments and Jane Harden carried it into the theatre.
“It’s a big responsibility,” said the sister chattily, “for a surgeon, in a case of this sort. It would be a terrible catastrophe for the country if anything happened to Sir Derek O’Callaghan. The only strong man in the Government, in my opinion.”
Nurse Banks, an older woman than her superior, looked up from the sterilising apparatus.
“The biggest tyrant of the lot,” she remarked surprisingly.
“Nurse! What did you say?”
“My politics are not Sir Derek O’Callaghan’s, matron, and I don’t care who knows it.”
Jane Harden returned from the theatre. Sister Marigold cast an indignant glance at Nurse Banks and said briefly:
“Did you look at the hyoscine solution, nurse, and the anti-gas ampoule?”
“Yes, matron.”
“Gracious, child, you look very white. Are you all right?”
“Quite, thank you,” answered Jane. She busied herself with tins of sterilised dressings. After another glance at her, the matron returned to the attack on Nurse Banks.
“Of course, nurse, we all know you are a Bolshie. Still, you can’t deny greatness when you see it. Now Sir Derek is my idea of a big — a really big man.”
“And for that reason he’s the more devilish,” announced Banks with remarkable venom. “He’s done murderous things since he’s been in office. Look at his Casual Labour Bill of last year. He’s directly responsible for every death from under-nourishment that has occurred during the last ten months. He’s the enemy of the proletariat. If I had my way he’d be treated as a common murderer or else as a homicidal maniac. He ought to be certified. There is insanity in his blood. Everybody knows his father was dotty. That’s what I think of your Derek O’Callaghan with a title bought with blood-money,” said Banks, making a great clatter with sterilised bowls.
“Then perhaps”—Sister Marigold’s voice was ominously quiet—“perhaps you’ll explain what you’re doing working for Sir John Phillips. Perhaps his title was bought with blood-money too.”
“As long as this rotten system stands, we’ve got to live,” declared Banks ambiguously, “but it won’t be for ever and I’ll be the first to declare myself when the time comes. O’Callaghan will have to go and all his bloodsucking bourgeoisie party with him. It would be a fine thing for the people if he went now. There, matron!”
“It would be a better thing if you went yourself, Nurse Banks, and if I had another theatre nurse free, go you would. I’m ashamed of you. To talk about a patient like that — what are you thinking of?”
“I can’t help it if my blood boils.”
“There’s a great deal too much blood, boiling or not, in your conversation.”
With the air of one silenced but not defeated, Banks set out a table with hypodermic appliances and wheeled it into the theatre.
“Really, Nurse Harden,” said Sister Marigold, “I’m ashamed of that woman. The vindictiveness! She ought not to be here. One might almost think she would— ”
Matron paused, unable to articulate the enormity of her thought.
“No such — thing,” said Jane. “I’d be more likely to do him harm than she.”
“And that’s an outside chance,” declared matron more genially. “I must say, Nurse Harden, you’re the best theatre nurse I’ve had for a long time. A real compliment, my dear, because I’m very particular. Are we ready? Yes. And here come the doctors.”
Jane put her hands behind her back and stood to attention. Sister Marigold assumed an air of efficient repose. Nurse Banks appeared for a moment in the doorway, seemed to recollect something, and returned to the theatre.
Sir John Phillips came in followed by Thoms, his assistant, and the anæsthetist. Thoms was fat, scarlet-faced and industriously facetious. Dr. Roberts was a thin, sandy-haired man, with a deprecating manner. He took off his spectacles and polished them.
“Ready, matron?” asked Phillips.
“Quite ready, Sir John.”
“Dr. Roberts will give the anæsthetic. Dr. Grey is engaged. We were lucky to get you. Roberts, at such short notice.”
“I’m delighted to come,” said Roberts. “I’ve been doing a good deal of Grey’s work lately. It is always an honour, and an interesting experience, to work under you, Sir John.”
He spoke with a curious formality as if he considered each sentence carefully and then offered it to the person he addressed.
“If I may I’ll just take a look at the anæsthetising-room before we begin.”
“Certainly.”
The truculent Banks reappeared.
“Nurse Banks,” said the matron, “go with Dr. Roberts to the anæsthetising-room, please.”
Dr. Roberts blinked at Banks, and followed her out.
Sir John went into the theatre and crossed to a s
mall table, enamelled white, on which were various appliances concerned with the business of giving hypodermic injections. There were three syringes, each in a little dish of sterile water. Two were of the usual size known to the layman. The third was so large as to suggest it was intended for veterinary rather than human needs. The small syringes held twenty-five minims each, the larger at least six times as much. An ampoule, a bottle, a small bowl and a measure-glass also stood on the table. The bottle was marked: “Hyoscine solution. 0.25 per cent. Five minims contains 1/100 of a grain.” The ampoule was marked: “Gas-Gangrene Antitoxin (concentrated).” The bowl contained sterile water.
Phillips produced from his pocket a small hypodermic case from which he took a tiny tube labelled: “Hyoscine gr. 1/100.” The tube being completely covered by its label, it was difficult to see the contents. He removed the cork, examined the inside closely, laid down the tube and took another, similarly labelled, from his case. His fingers worked uncertainly, as though his mind was on something else. At last she took one of the smaller syringes, filled it with sterile water, and squirted its contents into the measure-glass. Then he dropped in the hyoscine, stirred it with the needle of the syringe, and finally, pulling back the piston, sucked the solution into the syringe.
Thoms came into the theatre.
“We ought to get washed up, sir,” he said.
He glanced at the table.
“Hullo!” he shouted. “Two tubes! You’re doing him proud.”
“One was empty.” Phillips picked them up automatically and put them back in his case.
Thoms looked at the syringe.
“You use a lot of water, don’t you?” he observed.
“I do,” said Phillips shortly. Taking the syringe with him, he walked out of the theatre into the anæsthetic-room. Thoms, wearing that air of brisk abstraction which people assume when they are determined to ignore a snub, remained staring at the table. He joined the others a few minutes later in the anteroom. Phillips returned from the anæsthetic-room.
Jane Harden and Sister Marigold helped the two surgeons to turn themselves into pieces of sterilized machinery. In a little while the anteroom was an austere arrangement in white, steel, and rubber-brown. There is something slightly repellent as well as something beautiful in absolute white. It is the negation of colour, the expression of coldness, the emblem of death. There is less sensuous pleasure in white than in any of the colours, and more suggestion of the macabre. A surgeon in his white robe, the warmth of his hands hidden by sleek chilly rubber, the animal vigour of his hair covered by a white cap, is more like a symbol in modern sculpture than a human being. To the layman he is translated, a priest in sacramental robes, a terrifying and subtly fascinating figure.
“Seen this new show at the Palladium?” asked Thoms. “Blast this glove! Give me another, matron.”
“No,” said Sir John Phillips.
“There’s a one-act play. Anteroom to a theatre in a private hospital. Famous surgeon has to operate on man who ruined him and seduced his wife. Problem— does he stick a knife into the patient? Grand Guignol stuff. Awful rot, I thought it.”
Phillips turned slowly and stared at him. Jane Harden uttered a little stifled cry.
“What’s that, nurse?” asked Thoms. “Have you seen it? Here, give me the glove.”
“No, sir,” murmured Jane, “I haven’t seen it.”
“Jolly well acted it was, and someone had put them right about technical matters, but, of course, the situation was altogether too far-fetched. I’ll just go and see— ” He walked out, still talking, into the theatre, and after a minute or two called to the matron, who followed him.
“Jane,” said Phillips.
“Yes?”
“This — this is a queer business.”
“Nemesis, perhaps,” said Jane Harden.
“What do you mean?”
“Oh, nothing,” she said drearily. “Only it is rather like a Greek play, don’t you think? ‘Fate delivers our enemy into our hands.’ Mr. Thoms would think the situation very far-fetched.”
Phillips washed his hands slowly in a basin of sterilised water. “I knew nothing of this illness,” he said. “It’s the merest chance that I was here at this hour. I’d only just got in from St. Jude’s. I tried to get out of it, but his wife insisted. Evidently she has no idea we — quarrelled.”
“She could hardly know why you quarrelled, could she?”
“I’d give anything to be out of it — anything.”
“And I. How do you think I feel?”
He squeezed the water off his gloves and turned towards her, holding his hands out in front of him. He looked a grotesque and somehow pathetic figure.
“Jane,” he whispered, “won’t you change your mind? I love you so much.”
“No,” she said. “No I loathe him. I never want to see him again, but as long as he’s alive I can’t marry you.”
“I don’t understand you,” he said heavily.
“I don’t understand myself,” answered Jane, “so how should you?”
“I shall go on — I shall ask you again and again.”
“It’s no good. I suppose I’m queer, but as long as he’s there I–I’m in pawn.”
“It’s insane — after his treatment of you. He’s — he’s discarded you, Jane.”
She laughed harshly.
“Oh, yes. It’s quite according to Victorian tradition. I’m a ‘ruined girl,’ you know!”
“Well, stick to the Victorian tradition and let me make an honest woman of.you.”
“Look here,” said Jane suddenly, “I’ll try and be an honest woman with you. I mean I’ll try and explain what’s inexplicable and pretty humiliating. I told him I wanted to live my own life, experience everything, all that sort of chat. I deceived myself as well as him. In the back of my mind I knew I was simply a fool who had lost her head as well as her heart. Then, when it happened, I realised just how little it meant to him and just how much it meant to me. I knew I ought to keep up the game, shake hands and part friends, and all that. Well — I couldn’t. My pride wanted to, but — I couldn’t. It’s all too grimly commonplace. I ‘loved and hated’ him at the same time. I wanted to keep him, knew I hadn’t a chance, and longed to hurt him. I wrote to him and told him so. It’s a nightmare and it’s still going on. There! Don’t ask me to talk about it again. Leave me alone to get over it as best I may.”
“Couldn’t I help?”
“No. Someone’s coming — be careful.”
Thoms and Roberts returned and washed up. Roberts went away to give the anæsthetic. Phillips stood and watched his assistant.
“How did your play end?” he asked suddenly.
“What? Oh. Back to the conversation we first thought of. It ended in doubt. You were left to wonder if the patient died under the anæsthetic, or if the surgeon did him in. As a matter of fact, under the circumstances, no one could have found out. Are you thinking of trying it out on the Home Secretary, sir? I thought you were a pal of his?”
The mask over Phillips’s face creased as though he were smiling. “Given the circumstances,” he said, “I suppose it might be a temptation.”
He heard a movement behind him and turned to see Nurse Banks regarding him fixedly from the door into the theatre. Sister Marigold appeared behind her, said: “If you please, nurse,” in a frigid voice, and came through the door.
“Oh, matron,” said Phillips abruptly, “I have given an injection of hyoscine, as usual. If we find peritonitis, as I think we shall, I shall also inject serum.”
“I remembered the hyoscine, of course, Sir John. The stock solution had been put out, but I saw you had prepared your own injection.”
“Yes, we won’t need the stock solution. Always use my own tablets — like to be sure of the correct dosage. Are we all ready?”
He went into the theatre.
“Well,” said Sister Marigold, “I’m sure the stock solution is good enough for most people.”
“Y
ou can’t be too careful, matron,” Thoms assured her genially. “Hyoscine’s a ticklish drug, you know.”
The sickly reek of ether began to drift into the room.
“I must say I don’t quite understand why Sir John is so keen on giving hyoscine.”
“It saves anæsthetic and it has a soothing effect after the operation. I give it myself,” added Thoms importantly.
“What is the usual dose, sir?” asked Nurse Banks abruptly.
“From a hundredth to a two-hundredth of a grain, nurse.”
“As little as that!”
“Oh, yes. I can’t tell you the minimum lethal dose — varies with different cases. A quarter-grain would do anyone in.”
“A quarter of a grain,” said Nurse Banks thoughtfully. “Fancy!”
CHAPTER IV
Postoperative
Thursday, the eleventh. Late afternoon.
Sir John waited in the theatre for his patient.
The matron, Jane and Nurse Banks came in with Thoms. They stood near the table, a group of robed and expressionless automata. They were silent. The sound of wheels. A trolley appeared with Dr. Roberts and the special nurse walking behind it. Dr. Roberts held the anæsthetic mask over the patient’s face. On the trolley lay the figure of the Home Secretary. As they lifted it on the table the head spoke suddenly and inconsequently.
“Not to-day, not to-day, not to-day, damn the bloody thing,” it said very rapidly.
The special nurse went away.
The reek of ether rose up like incense round the table. Dr. Roberts wheeled forward his anæsthetising apparatus, an object that, with its cylinders of compressed gases carried in an iron framework, resembled a gigantic cruet. A low screen was fixed across the patient’s chest to shut off the anæsthetist. Thoms looked at the patient curiously.
“He’s a striking-looking chap, isn’t he?” he remarked lightly. “Curious head. What do you make of it, Roberts? You’re a bit of a dog at that sort of thing, aren’t you? Read your book the other day. There’s insanity somewhere in the racial makeup here, isn’t there? Wasn’t his old man bats?”
Roberts looked scandalised.
