There was an interval between dances when we arrived. We pushed our way up to the buffet.
'Look at that!' Benskin said in disgust, pointing to a row of glass jugs. 'Lemonade!'
He reached across the table and picked up a half-full pitcher.
'I think we might stiffen this a little,' he continued, with a shifty glance over his shoulder towards the stage. 'Hold the jug, old boy, while I get my flask out.'
He tipped his flask of whisky into the drink and I added half my bottle of gin.
'That should be more like it,' Benskin said with satisfaction, stirring the mixture with a jelly spoon. 'Guaranteed to bring the roses to the cheeks. One sip, and never a dull moment afterwards.'
He was still stirring when Mike Kelly appeared at the table with one of the operating theatre nurses.
'Mind if we join the party, Tony?' he asked. 'I've got some rum in my pocket.'
'Put it in, old boy!' Benskin invited him. 'Nothing like a lemonade cocktail to get the party going. That's right, pour the lot in. You didn't have much left, anyway.'
'The best part of half a bottle!' Kelly said indignantly. 'It's all I've got, too.'
'Fear nothing,' Benskin said, stirring rapidly. 'I know of secret caches. Now! Let us taste the devil's brew.'
He poured a little in six glasses and we sipped it with some foreboding.
'It's strong,' Benskin admitted, gulping. 'Odd sort of taste. I suppose that rum was all right, Mike? You hadn't been palmed off with a bottle of hooch, had you?'
'Of course it was all right. I got it off the Padre.'
'Oh well, it must be the lemonade. Cheers, everyone.' We had almost finished the jug when Harris pushed his way into the group.
'You dirty dogs!' he exclaimed angrily. 'You've pinched my blasted jug of lemonade! I had half a bottle of sherry and some crиme de menthe in that, too!'
***
I did not remember much about the dance. Isolated incidents came back to me in flashes the next day, like fragments of a dream. I recalled two gentlemen doing the old-fashioned waltz with their partners, catching the tails of their coats together, and covering the floor with broken glass and the best part of two bottles of gin; other gentlemen overcome with the heat and having to be assisted to the fresh air; nurse Footte laughing so loudly in my arms I noticed her uvula waggling in the back of her throat, and my thinking how horrible it was. All the students were drunk, and the Matron, being unaware of such things, beamed and thought she was giving these high-spirited young men a great evening. The next morning, however, she democratically joined in cleaning the hall herself and was horrified to find a hundred and thirty empty spirit bottles tucked away in the potted palms, behind the curtains, in the seats of the sofas, and on top of the framed portraits of her predecessors in office.
The nurses' dance marked the end of the Christmas holiday at St. Swithin's. Everyone knew that the next morning the operating theatres would start work again, new patients would be admitted, lectures would begin, and the students would troop round the bare and gloomy wards with their Chiefs. But that night it was still Christmas, and the hospital was alive with marauding students who leaped on the night nurses while they made cocoa in the ward kitchens. And they, dear girls, screamed softly (so as not to wake the patients) before surrendering themselves to their students' arms. After all, there had to be some compensations for being a nurse.
12
In the New Year I began work in the out-patient department. It was my first contact with the hard routine of the general practitioner's surgery. In the wards the patients are scrubbed, combed, and undressed, and presented to the doctors in crisp sheets; but in out-patients' they came straight off the streets and examination is complicated by clothes, embarrassment, and sometimes the advisability of the medical attendant keeping his distance.
The department was the busiest part of the hospital. It was centred round a wide, high green-painted hall decorated only by coloured Ministry of Health posters warning the' populace against the danger of spitting, refusing to have their babies inoculated, cooking greens in too much water, and indiscriminate love-making. There led off from the hall, on all sides, the assortment of clinics that it had been found necessary to establish to treat the wide variety of illnesses carried in through the doors every day. There were the big medical and surgical rooms, the gynaecological department and the ante-natal clinic, the ear, nose, and throat clinic, the fracture clinic, and a dozen others. The V.D. department was approached through discreet and unmarked entrances from the street; in one corner the infertility clinic and the birth control clinic stood next to one another; and at the other end of the hall were the shady confessionals of the psychiatrists.
On one side was a long counter, behind which four or five girls in white smocks sorted the case notes from their filing cabinets and passed them across to the patients with the carefully cultivated air of distaste mixed with suspicion employed by Customs men handing back passports. There were telephones in the middle of the hall for emergency calls, and, outside every clinic door, rows of wooden benches that looked as inviting to sit on as a line of tank-traps.
The department was run chiefly by the hospital porters. These were an invaluable body of men, without whom the work of the hospital would immediately have come to a standstill. They were experts at such common tasks beyond the ability of the doctors as directing patients to the correct department, holding down drunks, putting on strait jackets, dealing tactfully with the police, getting rid of unwanted relatives, and finding cups of tea at impossible hours. They stood, in their red and blue livery, inspecting with experienced Cockney shrewdness the humanity that daily passed in large numbers under their noses.
As soon as a patient entered the building he came up against a porter-a fat one sitting on a stool behind a high desk, like a sergeant in the charge-room of a police station.
'What's up, chum?' the porter demanded.
The patient would begin to mumble out his leading symptoms, but he would be cut short with 'Surgical, you,' or 'Throat department,' or the name of the appropriate clinic. The porters were the best diagnosticians in the hospital. They unerringly divided the cases into medical and surgical so that the patients arrived in front of the correct specialist. If a porter had made a mistake and consigned, for instance, a case of bronchitis to the surgical side, the complications that would have arisen and the disaster that might have overtaken the patient were beyond speculation.
After passing the porter the patient visited the counter to collect his case notes. St. Swithin's kept faithful records of its visitors, and several residents of the district had been neatly represented by a green folder containing the obstetrical notes of his birth, an account of the removal of his tonsils, the surgical description of the repair of his hernias, a record of his mounting blood pressure, and details of the postmortem following the final complaint that carried him off. Clutching his folder in one hand, he took his place at the end of the queue seated outside the door of his clinic. The queue shifted up the wooden seat as each patient was called inside by the stern-faced nurse at the door: the movement was slow and spasmodic, like the stirrings of a sleepy snake.
For the first half-hour the patient amused himself by reading carefully through his folder of confidential notes, comparing in his mind what the doctors had written about him with what they told him to his face. After a while this became boring, so he read the morning paper. When he had exhausted the paper, he passed the remainder of the time in clinical discussion with his neighbours. This was the most attractive part of the visit, and a pleasure he had been storing up for himself.
Discussion of one's illness with neighbours on the bench was done with pride: the patients wore their symptoms like a row of campaign medals.
'Wot you in for, cock?' he began to the man next to him.
''Art trouble,' was the reply, delivered with gloomy zest.
'Anyfink else?'
'That's enough, ain't it?' replied the neighbour sharply. "Ow
about you?'
'The doctor says I am a walking pathological museum.' The patient rolled the syllables off his tongue deliberately.
'Go on!'
'I've got diabetes mellitus, 'emeroids, normocytic anaemia, chronic bronchitis and emphysema, 'ammer toe, cholecystitis, and an over-active thyroid.'
'That's a packet, all right,' his neighbour admitted grudgingly.
'And I 'eard 'im say I've got a positive Wasserman, too!' he added in triumph.
''Ave you 'ad any operations?' inquired a thin woman on the other side of him in a voice rich with misery.
'Not to date, touch wood, I 'aven't.'
The woman gave a loud sigh.
'I wish as I could say the same,' she remarked, shaking her head sadly.
''Ow many 'ave you 'ad, missus?' asked the patient, anxious over his own record.
'Fifteen,' she told him, in tones of exquisite martyrdom.
'Coo! I'm glad I 'aven't got your complaint.'
'That's the trouble. They don't know wot's wrong with me. The last time they took out my colon. The doctor said it was the worst they'd ever 'ad in the 'ospital. Took them four and a 'arf hours, it did. Then they 'ad to leave some of it behind. I'm lucky to be 'ere now, if you ask me.'
'Must have been a bad do,' the patient said, respectful of such exuberant pathology.
'Bad do! I was left to die four times!'
'Oo's your doctor, missus?'
'Mr. Cambridge. Wot a lovely man! 'E's got such soft 'ands.'
I soon discovered another peculiarity of out-patient work. In the wards the patients are all ill: in outpatients' they are nearly all healthy. Men and women with organic disease formed a small fraction of the hundreds who came past the fat porter at the door every day. Most of them complained of vague aches and pains that they had been trotting up to the surgeries of their own doctors for several months, and they, poor men, had got rid of them temporarily by handing them a note to St. Swithin's. This was an example of an established medical practice known as snag-shifting, which went on just as actively in St. Swithin's itself.
The most usual condition in out-patients' was headache, which was slightly more common than troubles of the poor feet, giddy spells, the rheumatics, and insomnia ('Not a wink for forty years, doctor'). Most of the symptoms were manifestly incompatible with life if they had existed, but every patient had to be investigated in case something sinister lay beneath. This provided an excellent opportunity for snag-shifting. A persistent patient with headaches could, with a few strokes of the pen, be transferred to the eye department. It simply needed the houseman to scribble 'Headaches. Any eye signs?' on the notes and the patient moved to another queue outside another doctor's door. After the eye department had found nothing and were tired of the fellow appearing in front of them week after week they sent him to the throat clinic. The throat surgeons usually operated on all their patients and would probably remove his tonsils or the inside of his sinuses; when he continued to attend with his headaches afterwards, they would pack him off to the general surgeons with the suggestion his complaint was the result of sepsis lurking in his gall-bladder, kidney, or some other organ comfortably outside their province. The surgeons might operate or not, according to the length of their waiting-list at the time; whatever happened, after a few more visits to out-patients' he would find himself having all his teeth out in the dental section, who packed him off afterwards to the physiotherapy department in case the headaches-which continued-were due to disfunction of the neck muscles. From the physiotherapy department the patient went as a last resort to the psychiatrists, and as they were then unable to transfer him to anyone he probably continued to visit them and talk about his headaches once a week for the remainder of his life.
While I was working in out-patients' the hospital authorities installed a bar for tea and buns in the hall to break the tedium of the long wait. The regular patients were delighted, and showed their appreciation by spending as many of their afternoons as they could enjoying a medical tea-party with their fellow sufferers.
'Times have changed,' one of the old porters said gloomily, looking at the girl distributing cups of tea from the new counter. 'None of this 'ere nonsense in the old days. Mollycoddling, I call it.'
He wistfully described the routine of forty years ago. The patients had to be inside the building and seated at the benches by eight o'clock every morning. Then the doors were locked and anyone coming late had no alternative than to wait until the next day. The consultant arrived at nine, and strode to his room accompanied by a senior porter. When the doctor had settled himself in his chair the porter went to the door and shouted: 'Nah then! All them with coughs, stand up!' A handful of patients came to their feet and shuffled into the room. When they had been seen the porter returned and commanded: 'Stomach pains, diarrhoea, and flatulence!' The possessors of these alimentary disorders filed before the doctor while the porter marshalled the chronic cases who had come simply for a new bottle of medicine. The patients found the system convenient, and it was abolished only when the senior physician left for Harley Street after a remarkably heavy morning treating chest symptoms and found a stall outside the hospital from which was being sold 'Genuine St. Swithin's Cough Mixture.' This was bought off the patients for twopence and retailed to the public by the stallkeeper at sixpence a bottle.
We each spent two days a week in the accident room, where I began to feel I was at last learning a little medicine by discovering how to put a bandage on without dropping it on the floor, to sew up cuts, to remove foreign bodies from eyes, and to apply a kaolin poultice. A pair of us were obliged to sleep once a week in a couple of bunks in a small room by the accident entrance, to attend the minor injuries that trickled in unendingly during the night. This system was nearly the end of Tony Benskin. In his wanderings round the sleeping hospital he had met, and taken a fancy to, one of the night nurses, and turned himself into a red-eyed wreck all day by sitting most of the night in her company.
The conditions in a ward at night are admittedly lightly aphrodisiac. The nurse sits alone at one end of the long room, which melts away on each side into shadows and is illuminated only by a single red-shaded lamp on the desk in front of her. The soft warm light makes her as desirable as a ripe peach. There is not much room at the desk, so the student and nurse sit close together., To avoid disturbing the patients they must whisper, which turns every remark into an intimacy. They are the only two awake in a sleeping world and they draw together with a tingling sense of isolation.
The nurse mixes the student a milk drink from the patients' night rations. It is surprising what can occur in such conditions over a couple of cups of Horlicks. Their knees touch under the desk; their hands brush together in a determined accident; their fingers entwine and they sweat into one another's palms until the night sister is due on her round. The student pours soft endearments over the girl like treacle on a pudding, though his technique is sometimes ruined by his being interrupted in a delicate submission to her charms by a rough voice from the nearest bed demanding 'Can I 'ave the bedpan please, nurse?'
Benskin's romance might have ended harmlessly if it had not been for a lapse on the last night of our appointment. We were on duty together, and to celebrate 'the end,of the session we persuaded the casualty nurse to do our work and spent the evening in the King George. At closing time Benskin rushed to see his night nurse, while I flopped into bed.
Just after three I was shaken awake. Automatically I reached for my trousers, thinking it was the porter demanding my attendance in the accident room: but it was Benskin. He was in a pitiful state.
'Old man!' he said urgently. 'You've got to help me! Something terrible's happened!'
I tried to concentrate on the disaster.
'What's up?' I asked sleepily.
'You know that girl up in the ward-Molly. Remember, the one I've been popping up to see?'
'Umm.'
'Well-listen, old man, don't go to sleep for God's sake! To-night I nipped up to
see her as usual, and I was brimming over a bit with the old joys of spring and so forth owing to being full of beer…'
'Disgusting.'
'…and Christ Almighty, before I knew where I was I'd proposed to the bloody woman!'
I tried to clear sleep and alcohol out of my eyes, like soapsuds.
'Did she accept?' I asked, yawning.
'Accept! She said "Yes, please," as far as I remember. Don't you realize what's happened? Can't you see the gravity of the situation?'
'Perhaps she'll have forgotten by the morning,' I suggested hopefully.
'Not on your life! You know what these women are-at night nurses' breakfast it'll be a case of "Guess what, girls! Tony Benskin proposed to me at last and we're going to be married in May!" Oh God, oh God!' He clasped his head. 'It'll be all round the hospital by nine o'clock.'
'I gather you're not keen on the idea of marrying her?'
'Me! Married! Can you see it?' he exclaimed.
I nodded my head understandingly and propped myself up on an elbow.
'This needs some thought.'
'How right you are!'
'Surely there must be something you can do…can't you go back and explain it was all in fun?'
DOCTOR IN THE HOUSE Page 11
