‘Don’t touch these guts, laddie.’ Despite twenty years in London more than a hint of an Edinburgh drawl remained in MacDonald’s deep, quiet, reserved voice. ‘We’ll cover the lot with sterile saline packs blood-heat till we get him on the table. Yes, nurse, oxygen on ‒ and the foot of this trolley up on your highest blocks. Just fine … the bleeding’s stopped itself. I’ll deal with it on the table. If we start manhandling now, we’ll merely start it up again and be up to our armpits in gore.’ Mr MacDonald removed his jacket, rolled up his white shirtsleeves, helped himself to a mask, and glanced at the large, silent Night Superintendent. ‘Anaesthetist, pathologist and radiographer on the way in, Sister? Right. How soon can the theatre be ready?’
The Night Superintendent looked unhurriedly at the wall clock. She had been in charge of The Garden at night since the winter of 1945 and had never yet been seen to hurry on-duty, nor with her cuffs off. ‘Twenty-five minutes, sir. I sent my Night Sister to open department and get steam up five minutes back. She’ll need the twenty for boiling and ten for setting seeing this’ll be more than basic emergency.’
‘I’ll do him in twenty-five minutes, Sister.’ Mr MacDonald pulled on one pair of the sterile gloves waiting on the emergency dressings trolley as Nurse Blake whisked forward a steaming double-bowl stand. ‘Don’t waste time getting scrubbed, Mr ‒ Rolls, isn’t it? Just shove on a pair of sterile gloves and get on with these packs. If we don’t get them on stat, this chap mayn’t reach the table.’
‘Stat’ was short for the Latin ‘statim’. In English ‒ at once.
Not only reached the table, thought Joe Rolls, but at present showing likely to get off it with embroidered guts nicely bunged back in place. And he’d better not bloody collapse. Wreck this dour Scotch bastard’s statistics ‒ and if the bastard took much longer he, Joe, was going to die of heatstroke. He risked a glance across the theatre and grinned reluctantly to himself. Too bad he couldn’t open a book on who’d go down first, the night junior from Men’s Surgical, or himself.
Nurse Geraghty, the junior from the ward awaiting the patient on the table, was perched on a high stool against the opposite wall. She was a very chubby first-year, with a normally high colour and wide brown eyes. Her forehead was now scarlet and on that stool in theatre clothes she looked like an untidy bolster. Officially she was there both as ward escort nurse and anaesthetic nurse, but her only previous visit to the theatre had left a deep impression on Catherine Jason and Nurse Blake. ‘For God’s sake, nurse,’ said Catherine when she realised Nurse Geraghty was being sent to the theatre that night, ‘once that kid Geraghty has helped you and Henry lift the patient onto the table, sit her out of the way and tell her to stay put until I tell her to get off and not to do anything at all. She’s so well-meaning, but Heaven forbid that she should pick another pair of dropped forceps off the floor and put it kindly on the table like last time. Mr Gordon was sweet about having to stop the op. and change everybody and everything and as it was only a straight appendix the hold-up didn’t hurt the patient. This man tonight’s in a bad way ‒ and I hate to think of our new locum’s reaction to Geraghty’s helpfulness.’
‘I’ll deal with her, Sister.’ Nurse Blake was grim. ‘I can cope with Dr Edgehurst.’
‘Thanks, but be tactful, nurse. He was gassing for so long before anaesthetic nurses were invented that he loathes anyone breathing down his neck. If he wants anything, he’ll ask for it. If not, just keep an eye on him and stand clear.’
Nurse Geraghty was untroubled by her former theatre experience as she had already forgotten it. She was happy to sit down, rest her aching feet, and watch. Most of the other members of her junior set dreaded the theatre as it made them feel sick. Nurse Geraghty informed them it was no worse at all than her father’s butcher’s shop and what’s more there was no foul pong of damp sawdust. Nurse Blake had warned her not to watch the wound, but Nurse Geraghty was too interested to remember that warning. She was more observant than either she or any of her authorities in her convent school or the hospital yet realized. Catherine noticed her entranced stare at first with concern and then with growing interest. The kid’s not queasy and not noticing the heat, she thought. She’s green as they come, but I’ll bet, a born theatre nurse. Either you are or you’re not and I’m not. And unconsciously she did something she invariably tried to avoid in the theatre. She glanced at one particular wall. If that wall had had a window it would have exposed a view of the long ridge of downs that overhung Oakden.
Dr Edgehurst mopped his forehead with his gown sleeve. The heat was a trifle tedious but beneficial for the patient and his own arthritis. He’d known worse in India. Cold was another story and especially when the east wind blew in from the Channel with nothing to stop it till it hit the downs. He dreaded the east wind. Always touched up his malaria. But he was an Oakden man and after forty years in medicine during which he had been one of the few physicians of his generation to specialize in anaesthetics, the prospect of retiring to anywhere but his home town had been unthinkable. Three months ago when the recently appointed young Resident Anaesthetist at The Garden had resigned prematurely and taken a post in the United States, Dr Edgehurst had emerged from retirement to act as temporary consultant anaesthetist to the Group with the proviso that he would only work in The Garden until a permanent replacement could be found. Despite regular advertisements, the post remained vacant and daily at breakfast Mrs Edgehurst announced that the return to work would kill her husband and that Aneurin Bevan should be shot.
Dr Edgehurst tilted back his head to peer at Sister Jason. Efficient little thing and fetching. Very fetching. In all the green with only those great dark blue eyes and white unlined forehead exposed she frequently put him in mind of a wood nymph. Great pity. There it was. They would do these things. Useless to deny that wars and their immediate aftermaths produced crops of young marriages. Situation was as inevitable as the consequences of letting healthy young fellows use powerful machines on the roads. Bound to risk their lives seeing how fast they could go, and a great many lost the toss. Too many. This young fellow could too easily have been another. The fellow was luckier than he knew, and Dr Edgehurst shouldn’t wonder deserved, that young P.C. Gillon had been so quick off the mark and The Garden so handy. Even in a well-sprung ambulance with a good driver on a good road, Dr Edgehurst wouldn’t advise a twenty-nine mile drive for an eviscerated patient in severe shock. And if the fellow had reached Arumchester General alive, first he’d have been examined by the house-surgeon on Casualty duty, then the surgical registrar, and only then ‒ if they decided to call one in ‒ by an experienced consultant surgeon. All took time. Had to take time. But speed and experience were the two vital factors when dealing with road accident casualties, precisely as they had been for battle casualties. He knew. He should. He had served in the RAMC through two world wars. For those reasons, when he so frequently heard young Gordon and his colleagues lamenting The Garden’s lack of registrars, he was far from sure this was the disadvantage to the patients that all these bright young men of medicine and surgery appeared to assume. Admittedly the present situation made a deal of extra work for the consultants and particularly over weekends and holidays when they had to box-and-cox for each other, but any fellow who objected to hard work should not, in Dr Edgehurst’s opinion, have chosen the profession of medicine.
His stern grey gaze shifted to the crimson drops falling steadily through the glass drip-connection set in the apparatus of the blood transfusion running into a vein in the patient’s uninjured, back-splinted left arm. Going nicely. He peered under the anaesthetic mask at the pale, closed, superficially bruised and slightly swollen face. No lasting damage there and none to the head. Vital fact, that last. Also, the heart. Good heart and picking up very nicely. Not much longer now. This new fellow knew his job. Only to be expected in view of his professional position and reputation, yet somewhat unusual situation. Far from the type of locum little places like The Garden usually had to accept. Of course, o
ld friend of Alex Gordon’s, so naturally anxious to help. Widower, so young Gordon said. Wife killed in the war. No children. Unfortunate for the poor fellow but singularly fortunate for young Gordon. Poor fellow had been most distressed this morning. Mother asking him to come as soon as possible, young Evans in Italy, young Gordon responsible for both firms, and the Management Committee agreeing to allow him immediate unpaid leave-of-absence providing he found a suitable locum. Easier said than done these days what with all this brain-draining to the States and Canada. Then one telephone call to his old friend MacDonald had done the trick. Decent gesture, offering to postpone his holiday, but nonetheless, somewhat unusual. Consultant surgeons on the teaching staffs of large voluntary ‒ no, one must move with the times ‒ of large teaching hospitals, were not, in Dr Edgehurst’s experience, over-anxious to sacrifice even a few days of a holiday to work as unpaid locums in small places with no more than basic equipment and skeleton staffs.
‘How is he your end now, doctor?’ Mr MacDonald enquired as he had at intervals since the operation started.
‘Tolerating quite nicely, Mr MacDonald. Good young heart. Strong healthy youngster.’
‘Fortunately. Thank you, Dr Edgehurst. Count, Sister?’
‘All correct, Mr MacDonald.’
‘Good,’ he said, but as she expected, he checked the figures on the blackboard and the rows of dirty dressings on the mackintosh for himself before holding out his right hand for the threaded skin needle.
Dr Edgehurst watched the first of the final stitches and dried his forehead again. The heat was now beginning to remind him of India.
The temperature in Men’s Surgical Ward reminded Mr Parsons in Bed 6 of Egypt. All the french windows were open but there was no current of air in the twenty-bedded ward. At every entrance the mingled scents of lilacs, roses, cut-grass and warm earth were blocked by an invisible curtain of stagnant air heavy with old anaesthetic and new methylated spirit fumes, stale tobacco smoke, the sickly-sour smell of sweaty plaster of Paris, the aroma of hot rubber bed mackintoshes and the boiled-over coffee Nurse Geraghty had forgotten she had left brewing when summoned to the theatre. Only the insects penetrated the curtain; small clouds circled the dark green bulbs of the overhead nightlights; innumerable moths risked incineration; and the May-bugs fell like stones onto white sheets, pillows, and into the pool of greenish light on the night nurses’ empty middle table.
Men’s Surgical and its parallel neighbour in every sense, Women’s Surgical, had originally been erected as Nissen huts wards in the extensive back garden of the hospital during the second world war. Early in the peace the huts had been replaced by long, single-storey brick buildings. After the advent of the NHS ‒ some little time after ‒ the old low, fixed-footed, backbreaking for nurses, iron army beds had been replaced by new high, white hospital beds on castors and individual bed-curtains installed. The last innovation had not yet reached the rambling assortment of wards in the mid-Victorian mansion that had once housed the entire former cottage hospital. In the old wards and Casualty, screens were used for individual privacy, but only in Casualty were the screens new, white-curtained and on wheels.
The present theatre department had risen with the brick wards. All three were connected with each other and the old house by a broad, concrete, corrugated-roofed, open-sided ramp that cut across flower beds and lawn. ‘The lad that planned this ramp knew nowt about Kentish winters,’ the Night Superintendent had remarked when first showing Catherine round at night. ‘Hang about out here when theatre trolley’s returning in winter and you’ll likely be flattened. Mind you, birdcages over patients’ faces do a right good job. Not had the one pneumonia yet picked up on ramp.’ She sniffed. ‘Happen you’ll not’ve met birdcages in classy place like Martha’s, Sister. Look much like small bedcradles covered with linen with handles up top.’
Catherine looked intentionally blankly at her senior’s fleshy, phlegmatic face. Wherever you were in the war, she thought, you weren’t in London, duckie. ‘We called them birdcages too, Sister,’ was all she said. She wasn’t a masochist and the war was another subject she never willingly discussed.
Mr Parsons was a light sleeper and the only one of the eighteen patients in Men’s Surgical to have been woken by the senior night nurse’s preparations of the empty Bed 5 for the theatre patient. He watched dourly the trundling into position of the heavy black oxygen cylinder on its low wheeled stand, the lighter white metal portable blood transfusion-cum-drip infusion stand, the folding of the top bedclothes into a neat square ‘theatre’ pack, the arrival and immediate switching-on of a large electric bedcradle, the lining up of bed blocks of varying heights under the bed. The night senior had left the bed uncurtained whilst getting it ready to enable her to watch her ward simultaneously. Mr Parsons knew what all that carry-on meant. No more sleep for him tonight. He scowled with irritation rather than envy at his fellow-patients’ ability to sleep through the carry-on, the chorus of snores, grunts, clicks of false teeth, creaking bedsprings, jangling jars of lead weights hanging from traction-splints, the telephone in the small corridor outside the main ward entrance that never seemed to stop ringing and the May-bugs. The heat and the other insects Mr Parsons could stomach. Had to get used to both in Egypt, hadn’t he? But he couldn’t be doing with the May-bugs dive-bombing bad as the old Stukas. It might be a tidy few years since he’d last seen a Stuka, but he for one, had not forgotten ’em.
He slapped a falling May-bug off the single top sheet that in common with his fellows was all he could bear over him. Several of the younger men had removed their pyjama jackets. Mr Parsons had undone the top button and rolled up the sleeves of his blue and white striped jacket. He didn’t hold with sleeping mother naked with women around and most of them slips of girls not much older than his daughter; and he couldn’t wear his pyjama trousers as a decent man should, seeing his right leg was up in traction with a steel pin through the heel and an above knee plaster. Before that Mr Evans went on his holidays he said the plaster got to stay on the three weeks and he’d be back in time to change it. Mr Parsons wouldn’t be sorry to see this plaster go. Nasty messy job it was now and from the itching you’d reckon a battalion of ants was on a forced march inside. It was all right for Sister to say not to scratch under. Not got to stomach it, had she? Nor the aching that was playing up cruel tonight.
The night senior bent over him, smiling the smile that her boyfriend said turned him soft. ‘Know your trouble, Mr P.?’ she whispered. ‘You should’ve had the sleeping tablets the Night Super offered you on her first round.’
‘As you should know by now seeing it’s my tenth night, nurse,’ he retorted in a dignified flat murmur that carried far less than a whisper, ‘I don’t hold with taking sleeping tablets.’
‘I expect you’re right, Mr P.,’ she allowed and increased the voltage of her smile. She never argued with men or her seniors, and so was generally considered a remarkably sensible girl. The only members of the staff who dissented from this, were those in her own set, Joe Rolls, Catherine Jason and one of the non-nursing night orderlies. ‘Let’s get you more comfy. Dig in your good heel and upsadaisy! My goodness,’ she swept crumbs and wrinkles from the drawsheet, ‘we’ve had half the biscuit tin down here! Down we go ‒ just sit forward whilst I do your pillows ‒ and back ‒ better? Goody.’ She moved down the bed for a closer look at the alignment of his traction-splint, the position of the weights hanging over the foot of his bed, then backed a little before briefly checking his plaster in the light of her pocket torch. She managed not to wrinkle her nose. The smell was worse tonight, but in this heat, it would be. She switched off the torch. ‘How’s our leg feeling?’
‘I know as the tibia’s broken in more than the one place. Got to expect that.’
‘Afraid so. Got to be worse before we’re better.’ She looked more curiously at his square, sharp-featured face. In the greenish undersea night lighting his thinning fair hair always looked grey and his weathered complexion yellowish, bu
t somehow he looked older now. Probably the heat. ‘Fancy a nice cup of tea?’
‘I’d not mind one, nurse. Hot drink’ll be cooling. I could do with a bit of cool.’ He surveyed the ward professionally. He was a master bricklayer who had risen in his trade and now owned a prosperous local building firm. ‘They ought to fit air-conditioning in here. Wouldn’t be much of a job to put in and it’s not as if they’ve not got the money what with all we’ve to pay them for our stamps.’
‘What a good idea!’ Was it only the heat? Should she ring the office? She flicked her watch from her bib pocket. It was a bit of a bind that Sister Jason was held up in the theatre as the Gasworks would still be on her rounds in the house and the Gasworks got narked about unnecessary interruptions. Of course, if it was necessary ‒ she’d better take his pulse. ‘Just check the old ticker first, Mr P.’ She breathed out. Normal. No panic. Probably she was only going a bit up the wall as it was her last night before nights off, it had been too hot to sleep much today, and being in her third month on nights she was so tired. She looked up and down the sleeping ward. ‘I’ll just nip down to the pantry for your tea. I’ll leave the door open as I’m alone. Give me a whisper if anyone wants me.’
‘I’ll not mind doing that, nurse. Ta.’ Wouldn’t mind anything ‒ not his leg playing up, not the thought of the silly young basket that ran his van into the back of his car and got off with no worse than slight shock, a police prosecution and large insurance bill ‒ if only he could get a good night’s sleep. The wife kept saying he should have taken her advice and gone Private seeing The Garden still had the six private rooms up Maria Ward, business was doing well and he could afford it. He’d asked the wife when she’d ever known him pay the twice for anything. Women. All the same these days. Thought money grew on trees. He’d not say business could be a deal worse seeing there’d been so much bomb damage to clear up in Oakden and so many new houses wanted, but he’d not forgotten what it was like when he was a lad. Farm labourer all his life his old dad had been and never brought home more than the twenty-seven shillings a week. He couldn’t remember when his mum hadn’t looked an old woman, though when she’d passed on ‒ rest her ‒ she’d been five years younger than himself now and he was forty come Michaelmas.
A Weekend in The Garden (The Jason Trilogy Book 2) Page 2
