‘Yes, Matron.’ Josephine sounded tired suddenly.
‘And since you yourself mentioned the group discussions, may I make a suggestion? Could we perhaps choose to discuss method and orderliness at our first meeting? I think I must be the chairman for the first time, and I’ve been casting about for a suitable subject. This might make a very useful one——’
‘Do you want the others to tell me that I’m wrong, then?’ Josephine said quickly. ‘Because——’
‘Nothing of the sort,’ Elizabeth was soothing. ‘They will have no knowledge of this discussion between us. And the meetings won’t be designed to set up one person as an Aunt Sally for everyone else. They will be a chance for people to talk about their own ideas, that’s all. You may be able to convince me I’m wrong——’
She turned to go, Josephine automatically falling into step beside her.
‘Please don’t feel hurt by this little talk we’ve had, Sister Cramm. I’m well aware of your immense value to the Royal. I want only to help you do an even better job than you are doing—and to give you something to think about. I hope you will.’
Josephine watched her go, and turned back to her ward, to the quietness and peace of it, and stared round in a state of considerable unhappiness. Somehow it had lost its power to reassure. She felt almost naked, as though her uniform had been pulled off her back, and she shivered suddenly, before hurrying down the ward to the nurse at the linen cupboard. The girl was putting hand towels next to the dressing towels, and if she did that, someone would be sure to pack the wrong ones in the drums. No matter how often you told them, they never seemed to remember.
SEVEN
Elizabeth was almost the last to arrive in the consultant’s dining room which was used for the committee meeting. It wouldn’t do to let them think she had time to spare to sit about and wait for them. Mr. Heston, at the head of the long table, surrounded by papers, rose to his feet as she came in and greeted her with a booming heartiness.
‘Ah, Matron, good afternoon! Good of you to be so punctual. We’ve a lot to get through this afternoon! Perhaps you would sit here—and here is your copy of the agenda——’
He fussed with papers, and Elizabeth settled herself in the chair at the foot of the table, opposite his own, to which he had led her, and while ostensibly reading the agenda, took stock of the men around her.
On her left Jamieson sat sideways, his long legs sprawling, staring out of the window at the foggy afternoon in apparent boredom. He had nodded his greeting at her, and now seemed to be disinterested in her presence. Beside him, Sisson sat with his heavy shoulders hunched, staring down at his own agenda, his face set in a sulky expression. On the other side of him, two men, Michael Norton, a surgeon, and Albert Jessolo, the gynaecologist, were in quiet conversation, and beyond them, Sir Peter Jeffers, his body looking lost inside his elderly morning coat, sat muttering to himself as he peered at his own agenda.
Of the five men on the other side of the table, Elizabeth was aware of only one, James French, who sat in the centre of the row, his head to one side as he listened to the conversation between the paediatrician and the Ear-Nose-and-Throat man on his left. As Elizabeth put her agenda down and folded her hands on the table, French caught her eye, and bowed his head with an ironical look on his face. She allowed herself a small smile, and then looked calmly down the table at Heston, who was now making small coughing noises, preparatory to opening the meeting.
‘Well, now gentlemen, before we start on the first item, I am sure you would like me to welcome Miss Manton, our new Matron, to her first committee meeting with us. I am sure she will have much of value to offer our deliberations, and on your behalf I would like to assure her that we will be very happy to answer any queries she may have—though we have a great deal to get through today——’ The men moved slightly, and nodded, and Heston smiled at Elizabeth and bowed, and immediately forgot her.
‘First, then, Item one, finance sub-committee report.’
Jessolo coughed, and leaned forward to gabble the finance report, and Mr. Goldman, the E.N.T. consultant, cut in with an argument about the refusal to buy a new audiogram for his department. Elizabeth listened to the wrangling that ensued, and let her thoughts slide away.
There was really only one item on this agenda that concerned her, the allocation of the beds in the old Light Department, now called Mary Cooper Ward, and this was well down the list, set just before Any Other Business. She could feel French’s eyes on her as she thought about it.
How powerful could she be in the matter? It was hard to say. According to French, the most important argument against his request for them would be the nursing problem. If this was in fact so, then she would have a good deal of power. And French wanted her to use it on his behalf.
She began to doodle on her copy of the agenda. When to use that power, that was the question. Now? If she did that, would French no longer have any need for her in her position as Matron? And if he no longer needed her as Matron, would he be prepared to consider her as a woman?
She had few illusions about James French. She knew perfectly well that he had never felt anything stronger for her than an intellectual interest. She had never aroused in him any real emotional response. She felt a sudden anger rise in her. It was so unfair, really. He had always had an intense physical attraction for her, one that had first excited her, and then depressed her. It wasn’t just his good looks—she had never been a woman who found a beautiful face and muscular body particularly interesting. Indeed, the sort of man she admired most was the bony ascetic type. The two men she had enjoyed affairs with in the past had been like that. She had enjoyed them, and then discarded them when they had become boring to her and bored with her, and with no regrets on either side.
But this man, who could make her aware of his presence in a room as no other man ever had, wasn’t like them. He would never bore her either physically or mentally, and it was this realisation that made her angry. It wasn’t that she nursed a romantic love for him—she wasn’t the type to love anyone in that way, she was sure. But this violent feeling he could arouse in her—and she was adult enough to recognise it as uncomplicated physical desire—it was infuriating.
If it had been less strong, more like the pleasant stirrings her previous lovers had caused, she could have enjoyed the present situation more thoroughly. It would have been amusing to juggle with him, to plan a campaign to get him as a lover, if it had not mattered so much that she should succeed.
But it did matter. She wanted him, and if she failed to get him, she would suffer. This clamouring need that their remeeting had brought back so sharply complicated matters so.
She looked at her doodles, and her sense of humour came to her rescue, helping her to relax and think more objectively. She had drawn a series of circles, looping all round the print on the paper and had linked them so that they looked like a sinuous tube. All round the tube, she had drawn a series of mountain peaks, each peak behind two others, so that the drawing seemed to stretch into infinity.
‘And if that isn’t Freudian, I don’t know what is,’ she told herself in amusement. ‘Tubes and phallic symbols—ye Gods, how obvious can I get——?’
The afternoon dragged on, through interminable talk about house surgeons’ and registrars’ duty rotas, the parking problem in the main courtyard, the arrangement of Out Patient sessions to fit in with theatre lists and ward rounds.
But they reached Item six at last, and Elizabeth became more alert, and looked at Heston as he cleared his throat again.
‘Item Six—allocation of Mary Cooper Ward. Ten beds, in two five-bedded units. We have three applications for them here—Mr. Jamieson’s, who wants them to extend his existing bed allocation for general surgery, Mr. Sisson’s, who wants them for a gastro-intestinal ward, and Dr. French’s, who wants them for a purpose not yet fully explained. Any comments, gentlemen?’
Sisson leaned forward with the first sign of energy he had shown all afternoon.
> ‘Mr. Jamieson will forgive me, I hope, if I point out that his own bed allocation already exceeds everyone else’s. He’s got forty-five beds to my twenty—and even if these ten are given to the medical side, we still won’t have anything like parity with the surgeons. As I see it, we’re already out of balance at the Royal—far more surgical work than medical, and with all respect to surgery, you can’t run a hospital that way. It’s my medical unit that provides a good deal of the surgical work as it is—and the local G.P.’s are sending far too much good stuff outside the area because I can’t find beds for their people without keeping ’em waiting for months. And there’s turnover too. Medical bed turnover is—um—let’s see’—he ruffled his papers—‘ten days on the average, to a surgical turnover of five days. You get two surgical patients in to every one medical one as it is——Ten more beds, and you’ve put the balance out for good and all. I don’t see you can legitimately support your request, Jamieson, and since we know virtually nothing of French’s ideas, I’m hoping the committee will see this my way.’
He leaned back, and glowered at Jamieson, who had not moved during the time Sisson had been speaking. French made no move, but several of the other men moved slightly, showing discomfort. None of them had any desire to add to their own bed allocations, but they had a passionate desire to prevent Jamieson from adding to his. Jamieson had already managed to overload his own department with great success, using a mixture of sheer bullying at committee level and flattery of the nursing staff. Jamieson was very popular with the sisters at the Royal, and there were few of them who had not at some time helped him when he had wanted to poach other men’s patients, other men’s beds, even the services of other men’s registrars and housemen.
‘There’s no need yet for me to intervene,’ French thought. ‘The first step is to get Jamieson’s request turned down in favour of a medical demand.’ So he sat quietly, inscrutable as he listened.
For once, Jamieson put up a very poor fight. His application for the extra beds made available by the conversion of the old Light Department had been automatic. Jamieson always applied for everything that was going, but this time, he was not really ready for a new unit. So, he looked at Sisson, and contented himself with a sharp dig of the sort that had made him the most justifiably disliked member of the consultant staff.
‘I doubt it’s the shortage of beds that makes the G.P.’s send their medical work to the Central. They’ve well-known physicians there. We mustn’t—underestimate—the G.P.’s appreciation of that fact. They’ll use the best unit, no matter how slow the turnover. We get plenty of surgical work because we’re known to be good surgeons here——’
Sisson reddened and opened his mouth to hit back, but Heston, with many years of diplomatic experience behind him, cut in evenly with a request for nominees and seconders for the allocation of the beds.
Jessolo and Goldman, embarrassed and hot at Jamieson’s gratuitous rudeness to Sisson, stirred and spoke almost together. ‘Propose Mary Cooper for a medical unit under Sisson,’ Jessolo said, and ‘Seconded’ cut in Goldman.
‘Hmm. Well, before we can vote on that we must hear Dr. French, gentlemen. You put your application in without elaborating on your need for them.’ Mr. Heston looked down the table at French and nodded. ‘If you want them, now is the time to put your request formally.’
French leaned forward. ‘Thank you. I preferred to explain verbally rather than in writing. This way, I feel I can answer any queries you may have on the spot. I’ll be as brief as I can. Well, I’m right behind Mr. Sisson when he asked for more weight on the medical side—and it’s not just because I’m a physician, believe me. But, with respect, Mr. Sisson, you’ll agree you already have ten gastric beds, as well as your other general medical beds?’
‘So?’ Sisson grunted.
‘It’s been a long time since we turned any original research out of the Royal. Not since Sir Peter’s great work on endocrine influences on neoplastic disease——’
Sir Peter moved heavily, almost bowing in French’s direction.
His paper in the Lancet, and the interest it had aroused, was ancient history now, almost twenty years old. It had gained him his knighthood, providing the laurels on which he had rested comfortably ever since. He approved of younger men who remembered his past glory, and reminded others of it. And James French, who had fully intended to get this response from him, smiled deferentially at the old man, and went on smoothly.
‘I’d like to see us build on the reputation Sir Peter made for us here. I’d like to see these ten beds allocated to another piece of original research.’
‘Like what?’ Sisson said roughly. ‘Takes more than beds to do research, French. Money. Lots of it—I’ve told you that before. Where do we get it? And for what sort of research? Sir Peter got twenty thousand or more to spend on his little job—and that was before this bloody N.H.S. You tell me what research you can do in ten beds, and on peanuts, and I’ll listen.’
Sir Peter moved angrily in his chair and glared down the table at Sisson, his wet eyes in his St. Bernard’s dog face showing more intelligence than they had for a long time.
‘My “little job”, as you put it, Sisson, cost five thousand, not twenty. Get your facts straight. And most of it was spent on equipment we’re still using in the pathological department. So there’s no need for you to try to stop a young man with a bit of enterprise by moaning about money. If there’s a good piece of research to do, the money’ll be found.’ He turned in his chair and glared at Heston. ‘Propose we hear Dr. French’s application without unnecessary interruption, Heston. Let French get on with it in peace.’
James, careful not to show his pleasure, murmured his thanks up the table, and then leaned forward, his arms folded in front of him, every line of his body depicting the young man of vision and enterprise. Sir Peter seeing, as French intended him to see, a vision of himself in youth, nodded encouragingly.
‘I’m interested in something rather similar in some ways to the matter that interested Sir Peter. He wanted to investigate endocrine effects on neoplastic disease. I want to investigate metabolic effects on mental disease. You’ll have seen that there have been several papers already on organic causes of the cyclical mental disorders—the surgical treatment of the psychoses, drug therapy for the schizophrenics and paranoids, and so on. What I’d like to do is see what effect controlled diet can have on some of the neuroses—I think Freudians may be barking up the wrong tree. I’d like to use those ten beds for ten neurotic patients—admitted to be non-responsive to traditional pyscho-therapy and other treatment, and see what happens to them on particular dietary regimes——’
Jamieson snorted with sudden laughter, opening his mouth wide as he stared insultingly across at French.
‘You mean you want to put ten lunatics in those beds, and feed ’em on some weird vegetable diet, like a spa proprietor or something? What is this? A hospital, or a home for cranks? Research, by all means, but for Christ’s sake, French, think of something a bit better than that! I never heard such a lot of cock in my life!’
‘You’ll forgive me, Mr. Jamieson,’ French said smoothly, ‘if I point out that this idea is hardly a new one, or particularly cranky. It’s no more cranky than the idea that leucotomy may relieve schizophrenia, or that electroconvulsive therapy can relieve depression. Some patients have already been helped by dietary treatment—take the children with phenylketonuria, for example. All I want to do is to take the idea a bit further, and work on the neuroses as well as the pyschoses——’
‘Can’t be done here,’ Norton said suddenly. ‘I’m not going to argue about whether the idea’s cranky or not—there’ve been cranky ideas that have come off before—but I for one won’t countenance the setting up of any mental unit here at the Royal. Bad enough the Ministry tried to make us do it last year. Well, we scotched ’em then—nursing establishment wouldn’t wear it. We’ve got a mental unit out at The Copse, and as far as I’m concerned, that’s enough. Once
get mental patients in a ward here at the Royal, and you’ll have the Ministry turning us into one of their fancy new hospitals. No, French. Anything else I might go along with, but not if it means mental patients inside the Royal. We’ve got a bad enough shortage of nurses as it is—and once we let it get around there’re psychiatric patients in the place, the nursing recruitment will go down even more.’
‘Norton’s right there, French,’ Sir Peter grunted. ‘Can’t afford to upset the nursing, and well you know it. Sorry, but I can’t support you on this. Find another piece of research, and I’ll be with you—but not this——’
‘Your point about the attitude of the nursing establishment last year is well made, Norton,’ French said. ‘And I must agree with you, Sir Peter—we can’t afford to upset the nursing. But we have a new nursing establishment now. A new Matron is a new establishment, I’m sure you’ll agree. Perhaps Miss Manton could give us her views on the effect of a research unit here? She may feel that a research unit, even though it’s handling pyschiatric patients, could be an attraction that would lift the recruitment figures——’
‘There’s still the money question,’ Sisson said sharply.
‘One thing at a time, Sisson!’ French said. ‘Sir Peter has already indicated that money can be found if necessary. Could we hear Miss Manton at this stage?’
The eleven faces turned to look down the table at Elizabeth, sitting calmly at the foot. She waited a second for complete silence, and then spoke, her voice pitched to an attractive softness, yet quite audible.
‘This is a little difficult for me, gentlemen. I have been here only a week—not really long enough to assess the true causes of the nursing shortage as it applies to the Royal. You must all realise, of course, that this isn’t a problem unique to the Royal. Every hospital, apart from the big teaching hospitals, suffers from it——’
‘But perhaps a research project here will make the Royal seem rather more like a teaching hospital, make it more attractive——’ French said quickly.
The Hive Page 10
