by Betty Neels
‘It’s all most interesting and beautiful and I could spend hours…but we do have to pack, Mother, and I’m sure Constantijn has things to do.’ She caught her mother’s eye with a compelling glance, causing that lady to lay down a Louis XV snuffbox she was examining and remark, ‘Goodness, so we have. You’ll forgive us if we go, Constantijn?’
He drove them back in the Rolls, Augusta beside him, and as he drew up before the house he gave her a sidelong glance and said warmly,
‘Thank you, Augusta—what a tactful and thoughtful wife you will make.’ He had spoken quietly so that she had barely heard him, which didn’t prevent her blushing so hotly that Tante Emma, getting out carefully between them, glanced at her niece and remarked that the dear child had an unusually high colour.
It was on their journey back that Augusta asked diffidently if he was going to remain in England or returning to Holland, and when he replied carelessly that he would be going back to Alkmaar within a few days but that he would be in London again shortly, she forbore from commenting further, sensing that, for some reason or other, he didn’t want to discuss it. And later, when they arrived at St Jude’s and she had bidden her mother goodbye and was standing with him in the entrance to the Nurses’ Home, he said merely, ‘Tot ziens, my dear girl, it was a pleasant weekend,’ and she bit her lip, for it wasn’t quite what she had expected. All the same, she said in a composed voice, ‘Yes, wasn’t it? Thanks for taking us, Constantijn.’ She put out her hand, to have it engulfed and held for a brief moment before she took her bag from him and went inside.
Upstairs in her room, changing back into her familiar uniform, she wondered why he had been so casual, and not finding a satisfactory answer, persuaded herself that he was probably a man who hated being demonstrative in public.
CHAPTER SEVEN
THE NEXT FEW DAYS were long and hot and busy, and even if she had wanted to think a great deal about Constantijn there was little time to do so, and that, Augusta admitted to herself, was probably a good thing.
She had half expected to hear from him, as indeed she did, in the form of a delicately arranged bouquet of sweet peas which arrived for her on the day after her return to St Jude’s, but the card which accompanied it was disappointingly cool, bearing only the words, Yours, C. However, the flowers, displayed in various vessels around her room, called forth a great deal of interesting comment from her friends, and she put the card, businesslike though it was, under her pillow…for had he not said that he loved her a little?
It was on her fourth day back that the telephone rang as she was returning from Staff Nurses’ supper. Sister had gone for her weekend, it had been a busy day for it had been the first day of ‘take-in’, so that three of the five empty beds in the ward had already been filled. Augusta lifted the receiver, already busy planning which patient was well enough to be boarded out in another ward for the night so that she would have another empty bed. It was Archie, sounding for once serious.
‘Gussie? There’s a flap on—a block of flats has collapsed, somewhere down by the docks. We’re the nearest hospital, though we should be able to move some of the cases on once we’ve seen what they are. All the same we’re going to be busy. The big brass will be in presently, in the meantime get some empty beds, will you? The accident ward’s no dice—they’re full.’
‘I’ve two empties and I can get six more down the centre— Medical can take some of our up cases for the night…who shall I send over?’ She thought rapidly. ‘Mr Wills could go; he’s a simple dressing, and Jimmy Short and Clarke and Tippett…that’ll give us twelve beds.’
‘Good. Get on with it right away, will you? The RSO’ll be up to see you some time.’
She put the receiver down and picked it up again immediately because it rang once more. It was Matron this time. ‘Staff Nurse Brown? All day nurses have been recalled to their wards—you can expect them back shortly. Borrow any equipment they can spare from the accident ward and let me know if you are in difficulties. An Office Sister will be round presently.’
Augusta said, ‘Yes, Matron,’ then telephoned in her turn to Men’s Medical, the porter’s lodge, the linen room…she put the telephone down finally as Miss Hawkes, one of the Office Sisters, came into the ward.
‘I’ll need some dressing packs,’ began Augusta without preamble. ‘I’ve enough to cover the night, but not for an emergency. Is there anyone in CSSD yet, Miss Hawkes?’
‘There will be in a few minutes. Let me have a list—I’ll see you get them. What about bed linen? How many beds can you manage?’
Augusta told her. ‘And I’ve got Nurse Hobbs and Nurse Gibbs here—they’re getting the men transferred to Medical. We can get their beds made up while the porters are putting up the spares.’
Miss Hawkes nodded. ‘You realise that you may have to stay on duty until things settle down?’
Augusta said that yes, she did, thinking privately that it was the silliest question she had had to answer for a long time…still, poor old Hawkie, it was part of her job to ask questions, however silly.
They were almost ready when the first case came up. They had all made beds with an urgency inspired by the singsong sirens of the ambulances as they came and went. The nurses had returned long since and they had worked like beavers, for it wasn’t only beds—there were trolleys to be laid up, vacoliters of plasma to be arranged where they could be grabbed at once, forms laid out ready to be snatched, linen to be stacked, dressing packets to be piled in such good order that no one would need to fumble around. The night staff had come on duty too, and Augusta had to stop for ten precious minutes to give the report before they took over their normal duties in the ward, for despite the emergency, the patients still needed their usual care and treatment.
The RSO had paid a brief visit too. He was a tall be-spectacled man from Mombasa; as black as coal, brilliantly clever and rejoicing in the name of George England, he never appeared to hurry and nonetheless contrived to be where he was wanted most. He was one of the most popular men in the hospital. He said now, ‘Hullo, Gussie,’ and because there was no time to waste: ‘Ninety families in the flats—one end’s caved in. Our team’s down there now—there’ll be a dozen more as well. The idea’s to send the orthopaedic cases straight to Duke’s and the head injuries to Maple Cross—the rest will be split up, so heaven knows what we’ll get. We’ll try and let you know before we send the patients up, but don’t blow your top if something comes up unannounced. Got plenty of staff?’
‘You must be joking,’ Augusta said cheerfully, ‘not that it makes any difference; we’ll manage, like everyone else.’
He nodded and grinned. ‘I’ll be in the accident room or at least they’ll find me if you should want me, but keep it to the urgents, won’t you? Sir will be in too.’ Sir was Mr Rogers, the senior consultant surgeon, a middle-aged man of deceptively meek appearance and a voice like a sergeant-major when things went wrong. Augusta lifted her eyebrows in mock dismay and flew back into the ward to harry the porters; there were still three more beds to put up.
The patients came after that, in a slow steady trickle and in various states of disablement. By one o’clock in the morning two of them had died, three had gone to Theatre and were now lying, surrounded by post-operative equipment—drainage tubes, suction pumps and the like—fighting, albeit unconsciously, for their lives, unaware that the nurses were fighting even harder. The rest of the admissions had a fair chance of pulling through, or so it seemed, and Augusta sent two nurses to make up the vacated beds once more, for ICU was full, and Archie, on a quick visit half an hour earlier, had said that there were still cases coming in, some of them pretty grotty. George England had appeared too in his theatre gown and boots, and taken a quick look at the casualties.
‘Managing?’ he wanted to know laconically.
Augusta, hot and untidy and notwithstanding, cool and alert said, ‘Yes, George, very nicely, thank you.’ As she was—she had been sent three more nurses and while there was a mountain o
f work to do, they were getting through it. Most of the admissions were in a state of shock, and while some of them were silent and uncaring of what was happening around them there were several who were restless and irritable. Presently and in turn they would go to Theatre, but for the time being they lay, most of them on blood transfusions and most of them too with their senses dimmed with morphia or pethedine. The nurses went quietly to and fro, adjusting drips, repacking wounds, moistening lips that weren’t allowed to drink, doing the hundred and one jobs that never came to an end, and Augusta going to and fro with them, working as hard—even harder, for she had the responsibility. When Matron came to the ward, it was with the welcome news that coffee and sandwiches had been organised for the nurses so that they could go one by one as they could be spared and swallow and munch hurriedly in the ward kitchen. Archie, busy over a patient who had collapsed, said cheerfully, ‘Ha! Must keep the lamps burning, eh?’ His little joke made them all laugh as the first nurse hummed gleefully to the kitchen. Augusta, syphoning a stomach tube, said, ‘Five minutes each, one at a time,’ and on the same breath, ‘Where’s Sir, Archie? Surely not in the accident room?’
He was drawing up methedrine. ‘Lord, no, he’s been in Theatre…brought reinforcements with him too; means George can be on the spot if he’s wanted. Old Halliday is in the other theatre and they’re doing as much small stuff as they can downstairs.’ He inserted the needle into a flaccid vein. ‘There’s a couple more to come up—ruptured spleen and a nasty lacerated face.’
Augusta tidied their mess with methodical haste and prepared to move on to the next patient. She glanced at the clock; it was almost three; she would ask, as soon as she could spare a minute, if two of the nurses could go to bed as soon as the two new patients were admitted. Someone would have to carry on once the day started; there were several part-time nurses due in and one or two nursing aides, but most of the patients needed skilled treatment and there wouldn’t be enough nurses on duty to go round. She was still puzzling it out when Matron appeared again, looking pretty and not in the least tired. Augusta, conscious of a strong desire to yawn, went to meet her.
‘You have two more coming up, I believe, Staff Nurse. Send your third year nurse to bed and one of the juniors as soon as you can, will you?’ She eyed Augusta thoughtfully. ‘I expect Sister will return as soon as possible. Until she does, or I can find someone to replace you, do you feel able to stay on duty? There will be a warm meal very shortly—you must take time off for that. Send your nurses as you think fit. You have Nurse Stevens with you, haven’t you? She’s senior enough to be left for a short time.’ She paused. ‘No, perhaps not—I’ll see that something hot is sent up to the kitchen for you, just in case you are needed urgently.’
Augusta brightened at the mention of food, for now that she came to think about it she was very hungry, and she imagined the other nurses were too. She thanked Matron with the warmth of anticipation and was told briskly to go away and get on with whatever she had been doing. Both patients had been warded by the time the last of the nurses returned from their hot meal; Augusta gobbled down a bowl of soup, but didn’t dare start on the eggs and chips keeping hot for her, for the man with the ruptured spleen was in a bad way—he would be going to Theatre as soon as the second litre of blood had run in. The man who had come up with him—the one with the severe face lacerations—was quite young and powerfully built and lay quietly staring at the ceiling. Augusta had been surprised to find his right arm heavily bandaged above the elbow and as she lifted it gently on to a pillow she said, ‘The doctor will be up presently—I can’t give you a drink until he’s been in case you have to have something more done. Does it hurt very much?’
He shook his head and winced at the movement. His face had been stitched and the stitches sprayed with Nobecutane so that it looked like a patchwork quilt. ‘I’m OK,’ he said a little thickly, ‘but I don’t like this thing.’ His eyes turned to his other arm, attached by needle and tubing to the drip at the side of the bed.
‘Oh, that’ll be coming down in next to no time,’ said Augusta comfortably. ‘You lost quite a lot of blood—this is the quickest way of getting it back inside you.’ She had a quiet hand on his wrist, taking his pulse. It was much too rapid, although he looked all right. All the same, before she went to a patient at the other end of the ward she warned Nurse Meek to keep an eye on him. Archie would be up in a few minutes to explain the bandaged arm; after all, they had told her not to expect details at once if they were pushed and the case wasn’t desperate.
She had just changed a drip when something, some faint sound probably, made her look round. The man she had just left was sitting up in bed tearing with his bandaged arm at the tube attached to the vacoliter. She started down the ward moving fast, but not fast enough—she was several beds away from him when he succeeded in pulling it out so that the blood poured from the vacoliter as the tubing swung free. Worse, the man was tugging at his bandage despite the efforts of Nurse Meek.
In the ensuing confusion, Augusta found time to feel sorry for her—she had only been out of training school a week; until that night the only blood she had seen had been theoretical—the vacoliter had been half empty, but its contents were sufficient to make a spectacular display; Nurse Meek made a small gasping sound and flaked out at Augusta’s feet. ‘Good grief!’ said Augusta, thoroughly exasperated, and spared a few seconds to make sure she was all right. Apparently she was, for she opened her eyes, smiled with hazy apology and turned on to her side to fall immediately asleep. Augusta stepped over her and ran to the other side of the bed just as the man dragged off the last of the bandage. ‘Leave your dressing alone,’ she said breathlessly and without any result whatever, for he brushed her hand away as though it had been gossamer and pulled the dressing off too, exposing a jagged wound just above the elbow—it had, she saw, been stitched, but probably a ligature round one of the blood vessels had slipped its knot, for it was bleeding fast.
The patient looked at her with the faraway expression which conveyed to her the unfortunate possibility of concussion which had been delayed or an unsuspected subaranoid—it really didn’t matter which, she thought wearily; he was going to be a handful. She gave up the unequal struggle to cover the wound, but concentrated on getting two fingers over the brachial artery and applying pressure, and was presently rewarded by the sight of the lessened bleeding. She would only have to hold on for a minute or two—Stevens had gone to Theatre to collect a patient; Stebbings had gone down for a well-earned tea break; it was just sheer bad luck that old Tom in one of the side wards should have fallen out of his bed not five minutes earlier and both night nurses were engaged in hauling him back in again—and poor Meek—she cast a quick look over the bed and saw that she was still sleeping, looking very comfortable despite the hard floor. She was even snoring gently. Augusta turned her attention to her patient and said sharply, ‘Oh no, you don’t, laddie!’ as he swung his other arm across, missing her swiftly ducked head by an inch or so. She had her back to the door so that she couldn’t look round when she heard footsteps, but she let out a relieved breath and called, not too loudly, ‘Stevens? Leave that trolley and telephone Archie or the RSO—anyone—and get them up here fast!’
‘Will I do?’ said Mr Rogers from behind her. He was still in his green theatre gown and cap and looked so ill-tempered and tired that she braced herself for any forthright remark he might make, at the same time aware that there was someone else behind her—a large hand came down over her shoulder and took over from her stiff fingers. ‘Shall I?’ inquired Constantijn, ‘while you get one or two things.’
She flew to the centre of the ward, searched for the packs she needed; added it to the trolley she had laid in expectation of just such an emergency as this one and whisked it back to the bed, the while her tired brain strove to wrestle with the problem of Constantijn being there. Sir was mumbling away to himself, but he stopped when she pushed the trolley close to him and said merely, ‘H’m—slipped ligatur
e, I suppose—looks like an intercranial pressure too…’ He mumbled some more and then said, ‘This is Doctor van Lindemann—he was dining with me—brought him along to give a hand.’
Augusta was unwrapping forceps and retractors and needles and gut; she did it neatly, without touching anything but their outside wrappings. She said briefly, ‘We’ve met—you’ll need the lamp, won’t you?’ and went, rather leaden-footed, to fetch it. She hadn’t dared to look at Constantijn yet because she had the absurd notion that if she did she might throw herself into his arms and burst into tears—she was still feeling lightheaded from his sudden, unexpected appearance. The patient had become quieter; Constantijn was fastening a tourniquet above the wound and holding him still without much effort. Against her better judgment Augusta looked at him; he smiled and she smiled back and Mr Rogers said to no one in particular, ‘So you know each other.’
‘Very well indeed,’ said Constantijn. ‘If you’re ready, I’ll change places.’
It was a slipped ligature all right. Sir, mumbling and grumbling under his breath, found it quickly enough and set to work to repair the damage. He had straightened his back and turned to take the gut dangling from the Cheatles forceps in Augusta’s hand, when his eye fell upon Nurse Meek, lying reposefully on the floor where she had fallen. He paused only for a moment and then remarked mildly, ‘You work your nurses hard, Staff Nurse. Is she all right?’
