Doctor On The Job

by Richard Gordon

  ‘Very droll,’ said Sir Lancelot.

  ‘All I waiting for now is one of you Britishers have a slight accident with a bus, or maybe a taxi would do, then you haul him into the famous St Swithin’s Hospital, and say, “By Jimminie, he’s a croaker!” Then you hook him up to the wunnerful breathing machine and keep him going off the electric mains till I got time to open up my patient here. And I slip one heart out and slip another one in, easy as changing my shoes.’

  ‘You’ve had considerable experience of heart surgery in Shanka, I take it?’ Sir Lancelot asked.

  ‘Oh, sure. Them slobs out there queuing up for heart operations. Our great Minister of Health, he organize that. Besides, I read all Christiaan Barnard’s book, all the way through.’

  ‘May I ask what precisely is the diagnosis?’ inquired Sir Lancelot, glancing at the patient, who seemed to have become greyer during the conversation.

  ‘Diagnosis?’ Professor Ding looked puzzled. ‘Oh, sure…he got the tetrology of Fallot. In fact, the cardiac works.’

  ‘Fallot’s tetrology is certainly a serious quadruple of congenital cardiac defects,’ observed Sir Lancelot, stroking his beard. ‘But surely, it usually comes to notice immediately at birth? And its unfortunate sufferers seldom reach adult life?’

  ‘He a case of arrested development, maybe?’ Professor Ding laughed again, slapping his patient hard on the back. ‘Well, we gotta be getting along, take a look round the town, maybe see the famous Marks and Spencers. We gotta get it all in while we can, hey?’ he demanded jovially of his companion. ‘This very minute, some poor Britisher maybe try looking up the underside of them lovely big red buses, then it’s coats off and sleeves up and get stuck in there digging.’ He clapped Sir Lancelot on the shoulder, grabbed his patient by the biceps, and hurried back to the sunlight.

  ‘The professor seems a jolly fellow,’ Sir Lancelot observed.

  ‘That patient doesn’t look remotely like one with a Fallot’s tetrology,’ the matron declared.

  ‘It may be some lesser cardiac defect. All professors tend to exaggerate. I suppose it’s an enormous prestige symbol for Shanka, having its own cardiac transplant. All the smaller countries have been eager getting into the act, including our own. They used to be contented with simply sporting their own national airline.’

  ‘Which was probably less lethal.’

  Sir Lancelot nodded. ‘I can never entirely disagree with the definition of cardiac transplantation as the only operation which kills two patients at once.’

  ‘Where is Shanka?’ asked the matron, frowning.

  ‘Search me. These African states seem to change names and regimes with bewildering speed. One day we shall wake up to find the Republic of South Africa become New Zululand or some such. The new rulers will pass a law saying “For black, read white”, and I suppose their exclusively black teams will face hostile anti-apartheid demonstrations whenever they appear at Lord’s or Twickenham.’

  Lord Hopcroft reappeared with a businesslike step, after instructing his chauffeur to wait. Sir Lancelot apologized that he had a clinic in St Swithin’s itself. ‘Matron will make you quite at home,’ he assured the patient, departing. ‘She and the computer share a certain empathy.’

  The matron led Lord Hopcroft across the lobby and through a small door in the corner beside the lifts. Together they walked down a narrow, whitepainted, empty, echoing corridor. The piped music was silent. The air-conditioning was several degrees lower. Lord Hopcroft could not fend off an intrusion of uneasiness.

  The corridor ended in a plain door marked CID.

  ‘What’s this?’ he asked sharply.

  ‘The Clinical Investigation Department, of course,’ the matron told him, he thought disdainfully.

  They entered a small, white room, starkly lit by fluorescent tubes. He noticed they gave her a bluish, corpselike complexion. In the centre stood a transparent plastic capsule, containing a plastic stool and a stand supporting a television screen.

  ‘That is the diagnostic box,’ the matron indicated. ‘Please do not approach until the red light flashes above the screen. Beneath it you will find three buttons, marked “Yes”, “No”, and “Uncertain”. You answer the questions which appear on the screen by pressing the appropriate one.”

  ‘But supposing I should make a mistake?’ Lord Hopcroft asked, surprised at the anxiety in his voice. ‘I mean, it would be quite feasible, like misdialling on the telephone.’

  ‘Please try not to. But all mistakes are automatically rejected, once the computer has created a model of your clinical profile. It will simply order you to return and repeat the test.’

  ‘But supposing it makes a mistake?’

  ‘The computer does not make mistakes. It is impossible.’

  ‘Then what happens next?’

  ‘According to your clinical profile, the computer will tell you to proceed through one of the two doors opposite.’

  The patient had not noticed them. They were hardly distinguishable from the white wall, one marked IN the other OUT.

  ‘“Out” leads directly to the street,’ the matron informed him. “In” leads to the next stage of diagnostic investigation, if thought necessary.’

  ‘Thought necessary by whom?’

  ‘By the computer.’

  ‘But doesn’t Sir Lancelot have a say in things somewhere?’ he asked uneasily.

  ‘Human agency is unable to interfere with the computer. There is some iced water in the corner. Good afternoon.’

  She left him. The door which clicked shut was handleless and almost invisible in the wall. ‘It’s a sort of medical dungeon,’ he muttered. He looked round nervously. ‘It all helps you to concentrate, I suppose.’ With both hands he tugged down the ends of his grey jacket. ‘What am I worrying about? Me, an important man, described in the newspapers as “Baron Bed-and-breakfast”? I’ve never had a day’s illness in my life, play two rounds of golf a week, don’t smoke, hardly drink, feel as fit as a flea –’ He jumped as the red light flashed, accompanied by a loud intermittent buzzing.

  Lord Hopcroft squeezed through a gap in the plastic dome. Instantly the flashing and buzzing ceased. He sat on the stool. Nothing happened. He drummed his fingers lightly on the screen and whistled a soft tune. He began to wonder if something had fused. The blank screen suffused a bright blue. A question appeared in silvery capitals.

  ARE YOUR PERIODS REGULAR?

  Lord Hopcroft scratched his head. He wondered for a moment if it referred to some mannerism of speaking. He decided it best to do nothing. After a minute the silvery question flashed several times, to be replaced with,

  ANSWER!

  He pressed ‘Uncertain’. The letters flicked away at once, replaced with,

  ARE YOU ON THE CONTRACEPTIVE PILL?

  He replied promptly, ‘No’. The next question asked,

  DID IT ITCH?

  After some deliberation, he pressed ‘No’ again.

  DO YOU GET THESE URGES OFTEN?

  ‘Matron!’ cried Lord Hopcroft.

  Only the echoes sounded in his ears. The question started flashing. In exasperation he pressed ‘Yes’. He was asked in quick succession DO YOU GET UP AT NIGHT TO URINATE?, to which he said ‘No’, MANY TIMES?, to which he replied ‘No’ again, and MORE OR LESS THAN A DOZEN TIMES?, to which he bad-temperedly slammed all three buttons at once. GO THROUGH ‘IN’ DOOR IMMEDIATELY, commanded the screen, then went blank.

  Lord Hopcroft had the impression of some fault creeping into the system. But he obediently quit the capsule and pushed open the door marked IN. Like most patients, he clutched a faith in his hospital and his doctors which was infinite, touching and potentially disastrous.

  The further room was similar but even more frightening. The signal above another television screen was already flashing and buzzing amid a scientific jungle of apparatus, all glittering metal and glass.

  PASS A SPECIMEN INTO THE YELLOW FUNNEL,

  the screen was ordering him.

 
In his agitated mental state, Lord Hopcroft found this difficult. The message flashed, to be succeeded with,

  ‘PLEASE TRY.’

  No luck.

  YOU MUST PROVIDE A SPECIMEN, the screen exhorted. THINK OF NIAGARA FALLS.

  ‘You bloody stupid thing,’ Lord Hopcroft cried angrily.

  KEEP CALM! it replied.

  ‘I utterly refuse to keep calm. If you must know, I’ve been secretly fed up with you computers for years. You’ve come to completely dominate our lives. You’re fickle, unreliable, and seldom give a straight answer. You refuse to accept the slightest criticism, and you overreact wildly at any attempt to correct your glaring faults. In fact, you’re exactly like women. And a damn sight more expensive to keep. Once I’m back in my office, I’m going to loose my computers into the street, and issue my staff with ledgers bound in lovely leather and quill pens.’

  ABUSE WILL GET YOU NOWHERE, it told him.

  ‘Yes, it will.’ He seized the screen furiously and tried to shake it, but it was rigidly anchored to the desk. ‘Furthermore, you seem to imagine I’ve got a bladder like a camel.’

  TAKE YOUR HANDS OFF ME!

  ‘You’re lucky I don’t smash your screen in.’

  YOU WOULDN’T DARE.

  ‘Yes, I would. You just see.’

  VIOLENCE IS DESPICABLE.

  ‘So is gross incompetence.’

  PLENTY OF OTHERS APPRECIATE ME.

  ‘Plenty of others appreciated Fanny Hill.’

  NOW NOW!

  ‘Matron!’ Lord Hopcroft’s voice rang out plaintively. ‘I want to go home. Let me out.’

  His only answer was the screen flashing,

  PASS A SPECIMEN INTO THE YELLOW FUNNEL.

  Lord Hopcroft stared round. He saw a second stand of iced water. He filled several plastic beakers and tipped them down the funnel, laughing wildly. The whole screen flashed several times. It said,

  YOU MUST ENTER HOSPITAL AT ONCE.

  ‘Nonsense,’ said Lord Hopcroft.

  The door behind him flew open, and two large men in high-necked white jackets seized him by the arms and carried him out.

  4

  Shortly after eight o’clock the following morning, at the workaday end of Chelsea’s King’s Road, where the boutiques and bistros give way to the football ground and the gasworks, a first-floor window shot up and a pale, good-looking, wild-haired young man in a frilled shirt and velvet dinner-jacket stuck his head through the curtains and remarked, ‘My God, it’s daylight.’

  He ducked back into the small room, staring at his wristwatch. He shook it and tapped it. A long struggle to keep up with swift-footed time seemed finally to have killed it. The softly-ticking bedside clock caught his attention. ‘My God,’ he said again. ‘And it’s Tuesday.’

  He stared round, wondering where his trousers were. The floor was plastic tiled, bare except for a bra, black tights, a crumpled dress. The bed was plain and narrow, jammed into the walls like a ship’s bunk. Half-covered by a sheet, long fair hair delicately curtaining her naked shoulders, both hands tucked under one glowing cheek, Faith Lychfield lay peacefully asleep.

  The young man gingerly touched her nose with the tips of his fingers. She remained exactly as she was, but her eyes opened instantly, as if by some reflex.

  ‘Hello,’ she said.

  ‘Remember me?’ he asked politely.

  ‘Of course. Wasn’t it a super party?’

  ‘It was great, terrific. And I thought it was going to be deadly boring. I mean, the Annual Ball of the Destitute Reclamation Society doesn’t sound extra swinging, does it? I only went along because somebody gave me a ticket. I thought it would at least take my mind off my work.’

  ‘It’s all a frightful charity swindle, really. I can’t see how the destitutes get much, once they’ve paid for all the champers.’

  ‘But of course, I never wildly imagined I’d ever meet anyone so tremendously exciting and so vibrant as you there,’ he told her in a sober tone, sitting demurely on the edge of the bunk in his shirt-tails.

  ‘You are sweet,’ she said, still in the same position.

  ‘I must have dropped off to sleep,’ he suggested lamely.

  ‘It was awfully late when we climbed in through that window. Almost dawn. It’s a wonder we weren’t arrested. Policemen seem to be so suspicious these days.’

  ‘But how do I get out? This is a woman’s hostel, isn’t it?’

  ‘Don’t worry. The old ducks in charge are tremendously free and easy. They have to be, or they wouldn’t get any voluntary helpers. Of course, my parents think it’s a cross between Holloway and a nunnery. Daddy has rather old-fashioned ideas.’

  ‘Daddy,’ he murmured, scratching his bristly chin. ‘It could be just a little awkward, you know.’

  ‘But, lovey! Daddy never need know you’d been here. Or that you’d ever met me. He keeps me away from the students as though they were lepers with bells.’

  ‘Yes, but I ought to be seeing daddy in –’ He shook his watch, put it to his ear, then remembered the bedside clock. ‘Thirty-eight minutes. I’m taking my surgery clinical in St Swithin’s at nine.’

  Faith sat bolt upright, hand to mouth. ‘Oh, Pip! You should have told me. I’d have set the alarm.’

  ‘The thought did pass through my mind. But I felt it would sound a rather prosaic suggestion in the circumstances.’

  ‘You’ll have to rush like the wind,’ she urged. ‘Daddy can be absolutely tigerish with people who don’t keep appointments.’

  ‘Yes, I’ll get a move on,’ he decided gravely. ‘But where are my trousers?’

  ‘Oh, dear, dear…’ Faith gazed round her cubicle, lit by a bar of sunlight evading the drawn curtains. ‘Did you take them off in here?’

  ‘It might have been outside,’ he admitted. ‘I remember we were in rather a hurry.’

  ‘Here they are!’ She tugged a crumpled pair of dark trousers from the bottom of her bed.

  ‘Thank you.’ He started putting them on. ‘I don’t honestly think it’s worth looking for my bow tie.’

  ‘But you are at least going to try taking the exam, surely?’ she asked with concern.

  ‘I shall have to.’ He gave a slight shrug. ‘Otherwise daddy will throw me out.’

  ‘Oh, no! You should have told me, Pip. I never imagined that you lived a life so desperate. I would have packed you back to your landlady for a cup of Ovaltine and a good night’s sleep,’ she told him firmly.

  ‘I would allow myself to be thrown out of far better places than St Swithin’s for last night,’ he assured her solemnly.

  She put her head on one side. ‘What’s your other name?’

  ‘Chipps.’

  ‘I don’t know anything about you. Except that I remember daddy mentioning your name now and then at home. It always seemed to make him rather excited.’

  ‘My own father’s a GP in the West Country. He was a student at St Swithin’s with yours. My mother writes poetry, which is published in the local paper. My auntie is matron of the Bertie Bunn Wing.’

  ‘Who’s trying to make Sir Lancelot Spratt,’ Faith said brightly. ‘Everybody knows.’

  Pip winced. ‘Sir Lancelot Spratt. I shall be looking him in the face –’ He took another glance at the clock. ‘In thirty-six minutes.’

  ‘You will have to shift a bit,’ she remarked, still sitting in bed.

  ‘I’ll get there. Don’t worry. Even if I have to steal a car. I really mustn’t fail this time. I think it would give my poor father a coronary. It’s my third try at the surgery, you see. And dad’s dreadfully keen that I should follow him as another doctor from St Swithin’s. May I see you again tonight?’

  ‘Of course.’ She pouted her lips for him to kiss briefly.

  ‘We have so many ideas in common.’

  ‘Yes.’ Her eyes shone into his. ‘The freedom of the individual –’

  ‘No police,’ he agreed with a nod. ‘No bosses. No landlords. No exams. No elite.’


  ‘Squatters’ rights –’

  ‘Housing on demand. Plus essential foodstuffs, transport, holidays and abortion.’

  ‘No cruel sports. Flog all huntsmen.’

  ‘Abolish the Army and the Navy. Also Ascot Week.’

  They looked at each other, almost breathless with their reforming zeal.

  ‘See you at six?’ he asked.

  ‘That pub opposite Chelsea Town Hall.’

  ‘Lovely. Where’s my shoes?’

  ‘In the bookcase.’

  He slipped them on. ‘I think that’s everything.’

  ‘Good luck for your clinical.’

  ‘It’ll be all right. I’m sure it will. I’ve never been so inspired before an examination in my life.’

  Faith blew him a kiss and he nudged through the door. Then she yawned, put her head on the pillow and shut her eyes. She had the day off, and saw no reason for such adventures to mar a morning’s lie-in. She had an intensely practical outlook, like her father.

  Unfortunately for his chosen career, Pip did not enjoy Faith’s talent for self-organization. This had rendered his admittance to the St Swithin’s Medical School a mystery, which deepened in the eyes of its consultants with every year that he somehow managed to remain in it. They started ascribing it to some unspeakable secret of the dean’s, remembered by Pip’s father from their student days together. The dean was even growing to wish that this was true.

  Pip stood on the kerb in the King’s Road, blinking painfully in the strong sunlight. He dissected his problem in an unusually deliberative way. Bus or Tube would never get him across London in time. His next decision was to lie groaning in the roadway until someone summoned an ambulance. But he reflected that would whisk him only into the casualty department of a more convenient hospital, where he knew from experience he would have trouble extracting himself for several hours. A police car might prove unco-operative. He would have to hail a taxi, normally a gesture of unthinkable extravagance for a medical student on his own. As he climbed inside, he remembered that he had no money.

  Shortly before five to nine, a pair of young men in white coats were anxiously pacing the wide, marble-walled, notice-bespangled entrance hall of St Swithin’s Hospital. The concourse was as usual crowded with people waiting, visiting or lost, either sitting, standing or being propelled horizontally, the mass cleaved by briskly trotting nurses, ambling brown-coated porters, and doctors of all ages and degrees of importance but all with the look of being required vitally elsewhere.