‘No.’ I changed quickly into theatre clothes. ‘Johnny Druro explained. There’s one thing that puzzles me ‒’ and by now there was only one thing. The situation was so serious that I had been able to shut my mind to everything but the job in hand. ‘As Mr Bernard Kidd can’t be here in time, why can’t we borrow that cranial man from Hilldown General, as we did once before?’
‘Because he is operating himself at this very moment. Taking out a tumour. He likes working in the evening, had started about an hour ago. You know how long tumours can take. Three-four-five hours. He’s promised to come out here as soon as he finishes. Mr Bernard Kidd should be here first.’
‘I see.’ I stared at her helplessly as I fixed my turban. ‘Aline, Johnny’s a good surgeon but a general surgeon. He’s no cranial king.’
‘We all know that. He knows that. But he has had a fair amount of head work. Inevitably, since people will persist in riding motorcycles without crash helmets,’ she added with rare warmth. ‘It’s too bad the poor fools can’t see what happens when an unprotected head hits a hard road, pavement, or tree at even twenty miles an hour. If only more people could come into a theatre on evenings like this one, maybe our surgeons wouldn’t have to grow old before their time mending the unmendable.’ She handed me a pair of white rubber overboots. ‘Johnny looked ten years older than twenty-nine when he came in just now. He’ll probably look twenty before we’re through. Once the physicians have this boy in a fit state to tolerate being touched, Johnny’ll have to decide what to do, do it, and then live with the decision for the rest of his life. Ah, well. Let’s move. Anaesthetic room for you. Sister Theatre’s taking the case, I’m “dirty”.’
I buckled on my belt. ‘I thought this was your free evening.’
‘And yours. I’d as soon work. I like Dolly and Henry, but I’m not really a party girl. I told Sonia I’d take her call. Her fiancé‘s down. Did you know?’
‘Yes. I met him on my way to Mark. Shall we go?’
The warning sign ‒ NO ADMISSION. OPERATION ABOUT TO COMMENCE ‒ glowed red over the doors of the theatre proper. Through the glass portholes set in those doors I saw the empty operating-table, Sister Theatre, sterile, gowned and gloved, already in place behind her instrument trolley, and a short, tubby theatre nurse, White’s friend Lester, tying the back strings of Arthur Jennings’s sterile gown. Another house-surgeon was scrubbing at the sinks; the lather was high above his elbows. The scrubbing-up sink reserved for the senior surgeon in charge of the case was empty.
The anaesthetic room was full of men with masked faces. Johnny alone was not in a gown. He had on a cap, mask, a long white rubber operating-apron tied round his waist and reaching over the tops of his overboots. The white cotton T-shirt, one of the type he always wore under his gown while operating, looked incongruously frivolous in that setting and against all the green.
Dr Spence was giving an injection into the heart muscle of the boy on the specially stiffened stretcher-trolley. The Resident Anaesthetist, a medical registrar, and a house-physician were helping. The R.A. was checking the boy’s blood-pressure; the registrar was attending to the blood transfusion; the houseman was maintaining the temperature of the worst injuries ‒ those to the skull.
Johnny and a posse of disguised young men of varying sizes, the annexe students, watched the four physicians. I noticed casually one of the students was very large, but did not look at him properly, being too concerned by all those physicians, particularly by the S.M.O. His continued presence on what was normally exclusively surgical territory was an ominous sign.
The boy on the trolley looked sturdily built, his jaw round and chubby. A huge electric heat-cradle arched over his body. The many temporary dressings covering the lacerations on his chest looked faintly golden in the cradle light. The transfusion stand was attached to the foot of the stretcher. The blood was running as fast as I had ever seen it through the glass drip connection set in the apparatus. There were two more vacolitres of whole blood waiting on the transfusion trolley, and an empty vacolitre on the lower shelf.
The upper part of the boy’s face, including his eyes and the whole of his skull area, was hidden by thick gauze packs, steaming slightly. The packs were being changed and rechanged to maintain blood heat by the houseman standing near the head of the stretcher, working from a dressing-trolley and double saline bowl stand. Nurse Lester slid round behind me, carefully balancing a replacement bowl on the open palm of one hand and exchanging it for one in the stand.
I could not see any injuries, and only that childish jaw line because the R.A. was holding an oxygen-mask in place instead of fixing it by the attached straps. No anaesthetic was being given yet. Only oxygen. The rise and fall of the little green rubber bag attached to the mask was far too weak.
The room was very hot and very quiet, the only sounds the hiss and bubble of the oxygen passing through the flow-meter. The students made room for me without looking round. I edged my way to the S.M.O.’s elbow. ‘Ward nurse from Mark, Dr Spence.’
Johnny’s head jerked my way as the S.M.O. looked at my belt. In Simeon’s ward nurses in the theatre wore their uniform belts over their gowns to identify their years, or the fact that they were trained, and distinguish them from the theatre nursing staff.
‘Staff nurse, eh?’ grunted Dr Spence. ‘Good. Get scrubbed, Nurse, then take over from Dr Fleming. Keep those packs warm. And when you’re ready, Fleming,’ he added to his houseman, ‘give Dr Lucas a hand with that transfusion. If that vein thromboses ‒ as I think it will ‒ you’ll have to cut down on the other leg. I don’t know how many pints this laddie left on the other side of the hill, but my guess is not much short of five.’
A student asked, ‘From his head, sir?’
‘Right radial artery. Where’s that theatre nurse?’ Lester squeezed her way between the students. ‘Long needle again, please, Nurse.’
When I returned with my wet hands held high the large student turned towards me and would have touched me if Johnny had not put out an arm and pushed him aside.
Dr Spence noticed I was back. ‘You know what to expect, Nurse? I’m afraid this poor laddie’s head isn’t particularly pretty.’
I said, ‘Mr Druro told me, Dr Spence.’
‘So long as you’ve been warned ‒’ and he went on with what he was doing.
That warning was necessary. When I first took over from Adam Fleming I thought, I can’t do this. I can’t touch it. I shall be sick. I must be sick. The hair on the back of my neck tingled, my hands were cold and damp, and my legs were heavy as lead. I managed because I had no alternative. Training most probably helped, but having to do it was the main reason.
Johnny’s voice, closer than I expected, asked, ‘How’s his heart now, Doc? From his respirations it looks as if he’s beginning to pick up.’
Dr Spence said slowly, ‘The boy’s got the hell of a good heart, and he is in very good shape. I agree with you. He’s beginning to improve. You can’t touch him yet.’ He was silent for a while. ‘Maybe ten-fifteen minutes. Maybe. Then it’ll be up to you, Johnny.’
‘I’ll face that one when we come to it,’ said Johnny. ‘Right ‒ now I’ll get scrubbed.’
It was more like half an hour, and three times Lester had come in to ask the position for the operating team before Dr Spence removed his glasses and rubbed them clean. ‘That’s the lot we can do for the laddie. Now let’s see whether the surgeons are going to kill him or cure him. Into the theatre with him.’
The young policeman was still sitting on the bench. He stood up and moved out of the way to let the slow, unwieldy little procession go by. The stretcher, transfusion, and anaesthetic trolleys, being all connected, had to be wheeled at the same time and speed. The speed was slow motion.
The students followed behind, and once inside the theatre scattered soundlessly against the walls like great green leaves blown by an unfelt wind.
Johnny and the two housemen stood a little back from the table so as neither to touch
nor be touched. They held their brown-gloved hands clasped high to the sides of their faces in boxers’ triumphant handclasps. There was nothing triumphant about their manner, and their eyes were guarded.
The theatre porters whisked away the empty stretcher trolley; the medical registrar and Adam Fleming disappeared to the wards. Dr Spence remained to give the anaesthetic himself, and perched like a stout green bolster on a high stool at the head of the table, the R.A. beside him.
Johnny said, ‘Packs off, please, Nurse Sands,’ and waited with his two colleagues while Aline removed them, then stepped forward, the three men in unison like a well-trained theatre chorus.
Sister Theatre nodded to Aline. The overhead lights went on. The light was bright and shadowless but not glaring because of the filters, the green of the walls, the floor, and our gowns.
Sister asked, ‘Lights right, Mr Druro?’
‘Yes, thanks, Sister. Dr Spence,’ asked Johnny without looking up, ‘how long have we got?’
‘I’m afraid that’ll depend on how much you do or do not upset him, Johnny.’ The S.M.O.’s voice was kind. ‘But that heart of his is on your side. Now we’ve given it something to work on it’s picking up all the time. Still very slow, but one would expect that with those skull injuries; but it’s strong. One of the best hearts I’ve come across.’
My work as a partaker was over for the time. I was an official spectator, and would later have to report to Sister Mark. I backed to a sink, washed my hands, then found a place near a wall where I could watch clearly, out of the way.
Aline, as official ‘dirty’ nurse, was very busy. (The ‘dirty’ nurse in a theatre does all the fetching and carrying and acts as liaison between the sterile gowned and gloved operating team and the clean but unsterile world of jar-lids, sterilizers, tops of dressing-drums, telephones, and doors, to name only a few. Nurse Lester was assisting her. In simple, or straightforward, operations only one ‘dirty’ was employed; on the whole it was a junior job. But when a very complicated case was on, as now, if possible a senior nurse ‘dirtied’ in our theatres, since the instrument nurse taking the case ‒ always the senior nurse in the department ‒ might well be so busy attending to the surgeons that she would have little time to keep an eye on the junior nurses. It was for this reason that in Simeon’s theatres only third-year, fourth-year, and staff nurses were members of the actual theatre staff.
Dr Spence looked over his glasses. ‘Honestly, laddie, I don’t see you can do a thing with that skull. It’s been shoved in like an egg.’
‘Not all of it.’ Johnny flexed his shoulders. ‘I’ll get out the bits that are pressing ‒ if I can ‒ then maybe think again.’
‘Thank God I’m not a bloody surgeon,’ announced the S.M.O. piously, pushing his spectacles up on his nose.
Johnny did not answer. He was standing staring thoughtfully at that head, the full extent of whose injuries were now plainly visible as Arthur Jennings had cleaned up and shaved all the superficially intact area. It did not look like a human head, any more than the invisible figure under the mountain of green sterile towels on the table looked like a human being.
There are occasions in life when time bears no relation to the clock or calendar. That was one of them. First I seemed to have been watching those three pairs of brown hands for hours, looked at the clock, and found it was only twenty minutes. Then after what seemed only another twenty minutes I looked at the clock again: an hour and a half had gone by.
‘All right your end, Doc?’ Johnny asked at regular intervals.
‘Could be better. Could be the devil of a lot worse. I don’t know what you’re doing up there in his brain, but he doesn’t seem to mind it.’
‘Then he’s in a minority of one.’ Johnny put a hand behind him. Sister Theatre rinsed a scalpel in warm, sterile saline, set it handle foremost in his waiting palm. ‘Thanks, Sister.’
He was, I thought watching him, what my Highland grandmother would have described as a ‘bonnie fighter’. Dr Spence was another. ‘Defeat’ was a word both men refused to understand.
Until that moment I had been very afraid. I had not seen how that boy on the table could possibly live more than a few hours. But then I realized how, first in Casualty, then with the physicians, then the surgeons, and then in the ward, every department in turn would refuse to allow him to die for different reasons.
Sister Casualty allowed no deaths in her department; Dr Spence was quite obviously determined to keep that heart ‒ over which he was so enthusiastic ‒ pumping magnificently; Johnny was not going to let a patient saved by the physicians slip through his surgical fingers; and when the boy reached Mark ‒ well, we did occasionally have to lose a patient in Mark, but not a young, healthy patient who had come through an operation. Simeon’s, I discovered, was full of bonnie fighters, and I found I was smiling behind my mask.
Lester was dealing mainly with the outside world of telephones and police officers. She had been coming and going, a plump green shadow, when the policeman I now thought of as ‘our policeman’ appeared at one of the glass portholes. She went out to him, returned to Sister’s elbow, and held out a note.
Sister Theatre’s mobile eyebrows shot up. ‘We now know our patient’s identity, Mr Druro,’ she announced quietly.
‘Good.’ Johnny did not look up. ‘Let’s have it, Sister.’
‘Patrick Joseph O’Leary. Age nineteen. Student at Hilldown Agricultural College.’
‘Parents?’
‘Waiting in Casualty now.’ Sister Theatre glanced back at the note Lester still held out. ‘On holiday from Belfast. Staying at the Tudor Rooms Hotel in Hilldown. He is their only child.’
The theatre had been very quiet, very tense. The tension increased.
Johnny said, ‘Ask Night Sister to fix them up here for the night, please,’ and the theatre was silent again.
About ten minutes later Lester came in with a short, slight man in a mask and gown. Sister Theatre’s eyebrows told me the newcomer was a V.I.P. I had a good look. It was Mr Bernard Kidd.
He caught Sister’s eye, shook his head faintly, came and stood by me, watching the final stages of the operation. He nodded occasionally to himself. He did not say a word.
In a few minutes Dr Spence, the R.A., and all the students were aware who was with us, but as he chose to remain unannounced, no one told the surgeons they were being watched by the man all Simeon’s considered the finest cranial surgeon in the world.
Eventually Johnny replaced the needle-holder on Sister’s trolley, Arthur Jennings put down his scissors, and Sister handed Johnny the special triangular bandage always used for cranial operations in our hospital.
‘Any news of Mr Bernard Kidd, Sister? I thought he’d be here by now.’
‘I am, Druro. Have been for some time.’ Mr Bernard Kidd stepped forward. ‘I saw no occasion to interrupt. You were doing well.’
Johnny fixed the bandage, and slowly peeled off his gloves. ‘That’s it, thanks, Sister.’ He turned to the pundit. ‘This boy’s got a good tough heart, sir. Made all the difference.’
‘Not quite all.’ Mr Bernard Kidd looked from the S.M.O. to Johnny. ‘Not quite all.’
The porters wheeled in the bed from Mark. It seemed another lifetime since I borrowed it from Simon. It was only three hours.
The night nurses were on duty and well into their night when we wheeled Patrick Joseph O’Leary back to the ward. His parents were there, their faces white and lined with fear.
Later, after I had handed over to the night senior relief nurse who had come to special their son, they came out to the ward corridor to talk to me.
Mrs O’Leary took both my hands. ‘The Sister told us you should have been off duty, but you stayed working all this while to be with our Paddy Joe ‒’ Her voice was choked by a sob. She laid her head on my gowned shoulder and wept.
She was not very young, but small and very plump. I held her in my arms, stroking her hair until she grew calmer. Her husband stood by, his face
creased. ‘It’s the shock, Nurse ‒ the cruel shock it’s been. You’ll understand the boy’s our only one, Nurse ‒ our only one ‒’ he said over and over again.
Mrs O’Leary raised her head, dried her eyes with the back of her hand like a child. ‘I have no words to thank you, Nurse,’ she said, and kissed me.
They went back to sit by Paddy Joe, and I went into the duty-room. Sister Mark, officially long off duty, was still waiting for me. ‘All right if I go down to the theatre to change, then come back for the report, Sister?’
‘If you don’t mind, my dear, we’ll take no more chances. I’ll give it you here and now, then you can go back to the theatre to change, and go straight off.’
When we left the duty-room after the report, Mr Bernard Kidd, Dr Spence, Johnny, Arthur Jennings, Night Sister, and the Mark senior night nurse were blocking the ward doorway.
Sister Mark murmured, ‘Off you go, my dear. Etiquette or not, I must have a word with Mr Bernard Kidd. See you Monday morning.’
I should have liked to stay to listen to that word, but it was one thing for old Sister Mark to cut through red tape, quite another for an acting staff nurse. I let myself out of Mark and walked slowly down the incline that ran across the ramp joining Mark with the theatre.
The night air was cold on my face after the heat of the last few hours in the theatre. It suddenly reminded me of the party so many of us had been missing, and then I had time to realize what Albert had told me about Johnny’s hunch. That must have been David with Sonia.
‘My favourite ministering angel!’ David jumped out of my thoughts and was standing in the theatre entrance. ‘I thought you’d never get back. I’ve been waiting for you ‒ and not that you deserve it after handing me the frozen mitt these last hours in here.’
‘So that large student man was you? Sorry, Dave, I didn’t recognize you. How’s the arm?’ He said his arm was absolutely splendid, and so was his halo that was now jammed over his ears because he had watched the op instead of staying on at Dolly Gray’s party. ‘But it’s all set for hours yet! Get out of that clobber, darling, up to your Home for fine suiting, and let us go and live it up together.’
Flowers from the Doctor Page 12
