Sister Antrobus didn’t look the slightest bit surprised by Miss Van Gilder’s comments. ‘Yes, well, anyway, please look after him, Nurse Tanner. The houseman has arrived and our senior casualty doctor, Dr Mackintosh, is on his way down. I think he wants to bring in someone from the infant health service, but there is no one available yet.’
‘Yes, Sister Antrobus, right away,’ said Pammy as she took her cue to remove herself from the presence of Miss Van Gilder.
Pammy threw her cape into the staff room as she passed by. She missed the hook and heard it slide down on top of all the other capes which had also missed the hook and sat in a pile on the staff-room floor. She took a quick glance at herself in the mirror. It was impossible for Pammy to walk past a mirror without sneaking a peep. She loved the new black eyeliner her mam had bought her and she’d hoped that, unlike on the wards, she’d get away with wearing it on casualty. So far, so good. She’d sidestepped Miss Van Gilder’s scrutiny and she wondered if Sister Antrobus had deliberately rescued her.
As she walked towards the waiting area, she looked around to see what the other nurses were doing. She already had the sense that it was going to be a case of learn as you go on casualty. Everyone looked much too busy to have the time to show her what to do or where to start and the tension in the atmosphere was palpable. Nurses were rushing about with trolleys and drip stands, the clip-clop of their shoes reverberating off the polished wooden floor. Against the perimeter wall were cubicles containing beds, some of them screened off with plain, sage-green curtains. A male nurse disappeared into one, carrying what appeared to be a bucket filled with plaster of Paris. Pammy could hear a faint whimpering from within. Another set of curtains were pulled back and a staff nurse waved at Pammy, handed a set of case notes to a doctor, made a brief comment and tripped across to Pammy.
‘Are you OK?’ she asked. ‘Is it your first time on casualty?’
Pammy only had time to nod before the nurse rattled on.
‘Thank God you’re here, it’s been mad. I’ve worked here for fifteen years and it’s no quieter now than it was during the war. We all thought once the bombing was over it would be back to normal, but the past couple of years have been mad. Mad, I say.’ She shook her head as if she couldn’t quite believe what she was saying herself.
‘Right, I have to be quick. There’s a blackboard and chalk in the office to mark up your patient’s name and details and we keep those on the board until point of transfer to a ward. That way everyone can see at a glance what is happening and where. When you wipe the details off, you fill in this daily record, in triplicate using the carbon paper. You give them to Doreen in the office and she keeps one and at the end of each day sends the other copies to Matron’s office and to Assistant Matron, so don’t miss anything off. Matron likes to know everything that happens on here during the day.’
Pammy instinctively took a deep breath and stood a little taller. She was going to be under close observation on casualty, one way or another.
‘You also have to record each case into this book.’ The staff nurse indicated a very large thick black book that was lying open on the desk. ‘We all use the patient notes here on the unit, doctors and nurses alike, and the notes leave here with the patients during transfer to the ward.’ She flashed a harried smile at Pammy. ‘We don’t normally have trainee nurses on here. Some of the sights could put you off nursing for life, but in truth, we couldn’t run the place without you all, so we’re very relieved you’re here, I can tell you. We even have a probationer – a Nurse Makebee; do you know her? – that’s a first for casualty too, but honestly, we are so busy. They had an RTA in here last night.’
Pammy looked puzzled.
‘A road traffic accident. Sadly, the driver and his passenger died. And we had a pair of twins delivered in cubicle three – decided to pop out before the porter could transfer the mother to maternity. She had no idea she was pregnant. Tiny, she was. Came in with abdominal pain and bingo, half an hour later she’s a mother of twins. Anyway, do you understand how we record what happens? It’s most important.’
Pammy blinked. ‘Er, I think so. Where do I get the patient’s notes from?’
‘There, on the ledge.’ The staff nurse pointed at a pile of buff-brown, pre-lined notes. ‘Doreen keeps them topped up. Come and meet her now.’
Pammy felt mildly embarrassed. Everyone who worked at the hospital knew of Doreen’s story. Pammy had noticed how pale she looked and the sadness in her eyes told their own tale. She spent her working day sitting behind a counter manning a telephone and hammering away at a typewriter, issuing forms in triplicate and dealing with difficult patients and exhausted ambulance drivers.
Doreen didn’t hear them approach as she tapped away on a sheet of paper that was to be inserted inside a set of patient notes.
‘Doreen, here’s our new student nurse.’
As Doreen turned, Pammy recognized her face from the front page of the Echo. She looked to Pammy as though she needed a good meal and a laugh. One of my mam’s Sunday dinners is what she needs, she thought.
Doreen raised a hand. ‘Hiya,’ she said. ‘Let me know if you need anything. I’m right here.’
‘Thanks. I think I have it all,’ said Pammy with a huge, encouraging smile that said, I know all about you and I’m here too. ‘I’m Nurse Tanner, by the way,’ she said to the staff nurse as they turned away.
‘Lovely. I’m Staff Nurse Imping and I’ve just taken a call for your patient from the infant health service registrar. Dr Davenport – he’s the on-duty houseman – is going to be in charge of the little lad with the help of Dr Mackintosh until the paediatrician arrives. He’s up on the children’s ward at the moment with the twins from last night. I think that little lad has been in here before. When you have his name, ask Doreen to look out his notes for you. She’ll be able to find them in a flash. All the ambulance drivers report to her and she clerks the patients in; the walking wounded do it themselves. Got all that?’
Pammy blinked again. ‘Yes, of course I have,’ she said and grinned.
‘Great. I know it’s a lot to take in, but there’s only one way to learn on casualty and that’s to be thrown in at the deep end. I’ll come back and see you when I’ve finished with this chap.’ She nodded towards a cubicle. ‘He sat on the gear stick in his new car and somehow the end came off and got lodged in his rectum.’ A loud roar echoed through casualty. ‘Oops, maybe not any more, eh!’ she added. ‘Looks like that one’s been sorted out now.’ And she disappeared behind the curtain.
Pammy grabbed a sheaf of notes from Doreen and walked over to the wooden chair in the waiting area where a young woman was sitting with an obviously poorly little boy on her lap.
‘Hello, love,’ Pammy said. ‘What’s up with you then, little mite?’ As she spoke, she sat down on the chair next to the young woman, extracted her pen from the long, thin pocket in her uniform dress and opened out his notes on her knee. She reached out and took the little boy’s hand in her own and smiled at him. He was obviously in distress.
Pammy and her cohort had spent a week studying lung disease with Sister Haycock. They had learnt enough so far to know that in Liverpool lung disease was a daily killer. Children and the elderly were particularly susceptible to chest infections, pneumonia and TB. They were victims of the thick, suffocating, soot-tinged smog produced by the cool, damp atmosphere around the River Mersey and the high number of coal fires in the city. Pammy had grown up on the dock streets and a bronchial baby was something she’d seen many times before.
The pretty young woman accompanying the little boy looked anxious and fretful.
‘Don’t worry, love,’ said Pammy as she placed her hand over the top of the young woman’s hand. ‘We can get him sorted out, I’m sure.’ But she could tell by the fearful look in the girl’s eyes that her reassurance wasn’t working and that the girl’s distress was deep rooted. She placed the back of her hand on the little boy’s forehead. ‘Well, I’ll just get a thermom
eter, but he doesn’t appear to have a temperature and that’s a good thing. What’s the little fella’s name? Can you say your name, love?’
The little boy looked up at the young woman, his eyes pleading.
The girl looked at him lovingly and obliged. ‘His name is Joe Lancashire and he’s nearly four. I’m his sister, Lily.’
‘Smashing,’ said Pammy. ‘Can you both go into the cubicle here and I’ll take down some details while we wait for the doctor to arrive.’
Five minutes later, Joe was lying down on a casualty bed with the cot sides up and a thermometer protruding from his bottom. Lily’s wasn’t sure Joe would have agreed to let her take him to the hospital if he’d known that was going to happen, but he was so distressed and finding it so hard to breathe, he appeared to neither notice nor care as he lay on his side with Pammy gently cupping his knees to his chest.
She removed the thermometer swiftly. ‘There, you see,’ she said as she wiped the thermometer, shook the mercury back down to the bottom and laid the thermometer down in an enamel kidney dish of diluted, opaque white Dettol. ‘His temperature is fine and that’s a relief. Now, just a few bits and pieces to ask you while we wait for Dr Davenport. What’s your address, love?’
As soon as Lily mentioned that they were from Clare Cottages, Pammy fought to prevent her eyebrows from rising. Clare Cottages were notorious across Liverpool and everyone knew the place was nothing like its name implied. It had been drilled into Pammy since she was a child that she was never to wander up towards the cottages.
Little Joe began to cry. Not loudly or with any obvious fear or anguish, just the gentlest of sobs, which came through trembling lips as his tears began to flow.
‘Oh, love.’ Lily bent over him as he lay on the bed. She’d had no time to tie up her hair that morning and it fanned out across the bed and buried her brother under a blanket of glistening chestnut.
‘He’s just a bit frightened, Miss Lancashire,’ said Pammy gently as she placed her hand lightly on Lily’s back. ‘It’s the unfamiliar surroundings, the strong smell. It used to scare me too, and I work here.’
Lily lifted her head. She was bent over Joe in an awkward position, but she slipped her arm under his shoulders and looked up at Pammy. ‘I think he’s probably too hungry to be worried about the smell. I didn’t have time to give him his breakfast before we left the house. He was just too poorly.’
Lily failed to mention that there was no breakfast to be had in the house and that Katie had gone to school with an empty stomach.
Today was payday down at the processing plant. It was Lily’s job to tot up the worksheets and prepare the pay packets with the amounts carefully worked out and written on the front of the envelopes in large, clearly distinguishable writing. In three years, she had never missed a payday at work. As she sat in the hospital waiting for the doctor to come and see little Joe, she felt panic rising inside her like bile. She was terrified that Mrs McConaghy would use her absence to not pay the men. Mrs McConaghy would be struggling. It was so long since she had calculated the pay, Lily was sure she would have forgotten even how to add up the worksheets. Amy wouldn’t have a clue and besides, over the past weeks, Amy had been coming into work later and later each morning.
In her head, Lily ran through the stages of the payday routine. She always had to complete the calculations by 2 p.m., at which point she placed the empty pay packets on Mrs McConaghy’s desk. Then the ritual began. The unlocking of the safe, while Mr McConaghy stood guard at the front door. The meticulous counting out of the cash into each envelope. The locking of the front door with the large set of jangling keys as Mr McConaghy came over to the desk and re-counted. The locking of the safe, and the ‘All clear, my dear,’ from Mrs McConaghy as the doors were once again unlocked.
And yet, to Lily’s amazement, despite the meticulous routine, they still managed to make mistakes.
When the bell rang at 6 p.m., the gate at the bottom of the wooden steps would be opened and the men would line up on the stairs and the balcony, waiting patiently outside the door for Mrs McConaghy to hand each of them their weekly pay, just enough to support a family until the following week. The distribution of pay was done in a man’s own time, not the McConaghys’. Mrs McConaghy liked to do it slowly, to ensure that each employee knew how lucky he was. She would often blow on her diamond ring and give it a polish on the sleeve of her cardigan before she began the handing-over process. It was as if this subconscious affirmation of her wealth imbued her with a feeling of security and superiority, though Lily was never sure if she knew she was doing it.
‘I’m two shillings short,’ was a common complaint and it would be met with groans from the men. A complaint always delayed the process by about ten minutes, which was especially unwelcome when the men were itching to get to the pub across the road.
‘Might be just as well if I took the pay straight to the Red Admiral and didn’t bother giving them the envelope,’ Mrs McConaghy would say to Lily as the last man filed down the steps and straight through the pub door directly opposite.
Lily was meticulous in her calculations and the mistakes were never any fault of hers, as the men well knew. It was always down to Mrs McConaghy, who somehow had trouble counting out the exact amount into each packet. Two shillings would put a meal on the table and no man could afford to be short-changed.
If Lily missed an entire payday, she knew there would be a commotion in the office and she was terrified that this might result in Mrs McConaghy seeking to have her replaced by someone from a more stable home environment. Someone without a poorly little brother. Her sister Katie had sensed her panic earlier that morning.
‘Shall I go to the hospital, Lily?’ she’d asked her when they discovered that both their parents were too drunk to rouse.
‘No, love, you go to school. You must never miss a day of school.’ Lily didn’t want to tell her that if her seven-year-old half-sister walked into the hospital with a three-year-old boy, the welfare office would be telephoned and neither of them would return home. They would be straight into one of the many children’s homes dotted around the city.
Pammy had already taken in the poor state of Lily’s and Joe’s clothing and yet it was obvious that someone had been making an attempt to keep the boy clean. His face was almost as white as his neck was black and a tidemark skimmed his chin and divided the clean from the dirty. He smelt strongly of camphor oil.
She had recently read an article in the Liverpool Echo about how, when the new housing was eventually built out at Huyton and Speke, the families from Clare Cottages would be the first to be relocated and the cottages would then be demolished. It had been confirmed as the worst housing in Liverpool. Infant- and child-mortality rates were higher in the cottages than in any other part of Liverpool.
‘How long has he been like this?’ she asked.
‘He was like it when I got home from work last night. I put some camphor oil on his chest, but this morning he was no better. He was panicking and he seemed really frightened. I’d never seen him like that before, so I thought I had better bring him here. He usually gets better after a few hours, but he’s been like this since last night.’
While Lily spoke, Pammy counted Joe’s respirations and took his pulse. ‘Where’s your mam?’ she asked and looked up sharply when there was no answer. She guessed that Lily was no more than seventeen, which surely meant she couldn’t be wholly responsible for such a young and poorly child.
‘She’s had to go to work,’ Lily lied. Lily knew the hospital was a dangerous place for her and the children. It represented authority, had links to the welfare board. She needed to keep her mouth shut. Her only friend was Sister Therese and she was at Mass. When she’d realized that, Lily had decided that Joe couldn’t wait. Even though her instincts told her to hang around at the convent until Mass was over and she could ask Sister Therese what to do, a stronger impulse drove her to rush to the hospital.
Dr Davenport pulled back the curtain with a fl
ourish and joined Pammy and Lily. He picked up the notes and said, ‘Hello, er, Mrs Lancashire?’ It was a question more than a statement as he looked down at Lily’s ring finger.
‘No, Doctor, I am Joe’s sister. Our mam is at work. She left before he woke up, so she didn’t know how bad he was and I thought I had better bring him down.’
Lily was talking faster than normal. She knew it and so did Dr Davenport.
Teddy smiled at Pammy, took his stethoscope out of his pocket and said to Joe, ‘Can I listen to your chest, young man?’
Joe nodded his head, his blonde hair bouncing and his blue eyes wide with apprehension.
Teddy blew on the end of his stethoscope to warm it and, placing it on Joe’s chest, listened hard as an expression of great concentration fixed his facial features into a deep frown. ‘Ah ha,’ he said loudly. ‘I thought as much. That watch I lost last week, Nurse Tanner...’ He was now looking at Pammy. ‘It’s in there.’ He tapped Joe on the rib cage, lightly.
Little Joe grinned from ear to ear, before he began to cough violently.
Turning his attention to Lily, Teddy added in a low voice, ‘The senior casualty registrar will be down from the children’s ward in a moment; he’s the doctor who actually knows what he’s doing. I thought I would just pop along and see if I could help in any way before he gets here. How is your breathing now, Joe? Is it worse than, say, last night?’
Joe nodded his head frantically.
‘Has the camphor oil I can smell filling the entire casualty department helped any?’
Little Joe opened his lips, about to speak, but Teddy put his hand on Joe’s.
‘On second thoughts, don’t you speak, little man. Best you conserve what breath you have for the vital questioning from the doctor who looks after the nearly-four-year-old little boys with trouble breathing. Not three or five, mind, we have other doctors for them, he’s just the nearly-fours man. He’s been waiting for weeks for you to arrive. Lives in a cupboard, he does, until one pops in. The last nearly-four-year-old we had in stayed with us for a little while, being looked after by these gorgeous nurses in pink dresses, and when it came time for him to leave, he didn’t want to go home. Can you imagine that?’
The Children of Lovely Lane Page 24
