The First Year

by Lucilla Andrews

  When we reached the theatre the porter drew me momentarily aside. ‘Your first time down, Nurse?’

  ‘Yes.’

  ‘Then just you hang on to his hand, Nurse, while he goes under. It’ll help him, and it’ll help you.’

  Chapter Three

  AN EVENING IN THE OPERATING THEATRE

  The general surgical theatre lay close to the main surgical wards. It was a large department, consisting of the theatre proper, with its encircling, but sealed-off, galleries; anaesthetic room; sterilizing room; duty-room; nurses’ and surgeons’ changing-rooms; glove-room; and instrument-room. The department was separated from the hospital by large, wide double doors; inside lay a broad white corridor, off which lay the various rooms; the theatre itself was at the end of the corridor. The patients and theatre staff were admitted to the theatre by means of another set of double doors; the galleries were reached by a staircase opening into the white corridor. When we had arrived at the outer doors a red warning notice glowed over the entrance, ‘Operation in Progress ‒ Approach with Caution.’ There was another illuminated red notice over the theatre doors ‘Operation in Progress ‒ No Admission under any Circumstances while this Notice is Red.’

  The porter guided Roberts’s stretcher-trolley into the anaesthetic room. ‘You’ll need a mask, Nurse,’ he whispered. ‘You dress up later when he’s under.’

  ‘Thanks.’ I took a mask from the large glass jar by the door, tied it over my face, and went back to Roberts. He smiled dreamily. ‘You do look queer in that yashmak, Nurse.’ His hand reached for mine again. ‘I’m glad they send a nurse from your ward down with you here. It makes a difference, somehow. You don’t feel so alone. I expect’ ‒ the expression in his eyes was anxious ‒ ‘this kind of carry-on is all in the day’s work for you? You bring a lot of chaps down?’

  I swallowed. ‘Oh, yes. Yes, indeed. It’s all in the day’s work.’

  ‘And ‒ you’ve seen lots of cases like mine? I mean, I’m not what you might call out of the ordinary?’

  ‘Of course not.’ I put all the confidence I could muster into my voice. ‘Just routine.’

  The porter hitched the anaesthetic trolley closer with one foot and tested the cylinders. ‘That’s a fact, mate,’ he said reassuringly. ‘Doing cases like yours all day long, we are. Must do hundreds every year. That Mr Waring, he’s a crack hand at this business. At it all the time. Now, you take this afternoon’ ‒ he leant a casual elbow on the cylinders ‒ ‘just one afternoon ‒ and how many is it we’re doing from Francis, Nurse? Eleven, isn’t it?’

  ‘Yes, only eleven,’ I replied, copying his casualness. Roberts relaxed.

  ‘Eleven. You don’t say.’ He smiled at us. ‘Well, I dunno, but it makes you think. And I dunno why it should, but it makes me feel better.’

  ‘Feeling better, eh, laddie?’ The anaesthetist had come in. ‘Good show. Now just let me have your right arm, and I’ll give you something that’ll make you feel even better.’ He pulled down his mask. ‘You know me, laddie. I’m the chap who looked at your chest in Albert last evening. Right? Good show.’ He nodded at me.

  ‘Just roll back his sleeve, Nurse. That’s the form.’

  When Roberts was unconscious the anaesthetist told me to go and dress up. ‘I’ll be with him all the time he’s under.’ The porter caught my eye.

  ‘Nurses’ changing-room. Door’s marked. Staff Nurse is in there. She’ll show you what to put on.’

  Without looking up, the anaesthetist asked, ‘First time down, Nurse?’

  ‘Yes, doctor.’

  ‘God help you,’ he murmured, ‘and you’ll need it. It’s hellish hot in there.’

  In the changing-room the staff nurse was recognizable only by her blue belt. She was hidden beneath a turban, mask, long enveloping white gown and white rubber over-boots. She looked first at my feet. ‘What size, Nurse?’

  I closed the door behind me. ‘Four and a half, Nurse.’

  ‘Help yourself to a pair of fives. We’ve nothing smaller.’ Then, noticing the uncertainty in my manner, she looked at me properly. ‘Don’t tell me they’ve sent us another first-year! Are you the P.T.S. set too?’

  ‘Yes, Nurse.’

  She groaned. ‘Not another green pro.! What’s going on in Francis Adams this afternoon? Who sent you down?’

  ‘Nurse Bennings, Nurse.’

  She muttered something under her breath about staff nurses who thought other staff nurses had nothing to do but hold the heads of fainting pros. My heart sank. Poor Josephine. Poor me.

  ‘Here.’ She handed me a gown. ‘Put that on over everything, and I’ll show you how to fix your turban.’ She did so, efficiently. ‘That’s it. Now tie your mask on again. Then find yourself some boots from that cupboard over there.’ When I had the boots on she studied my appearance. ‘You’ll do.’ Then she dropped her brusque manner. ‘Feeling scared?’ she asked kindly.

  ‘A bit, Nurse.’

  Her eyes smiled over her mask. ‘Poor kid. I’ll bet you are. But don’t panic. You aren’t going to see any awful sights, as your man will be completely covered by sterile towels, and you’ll only see the operation site, which will look like nothing you’ve ever seen ‒ and certainly nothing human. And don’t feel that you’ll be expected to do anything, as no one will expect you, a new pro., to do anything. You just have to be there, to keep an eye on what’s going on, so as to be able to give a report to your ward sister when you get back to the ward. But at your present stage you needn’t fret about missing some vital point, because, of course, you’ll miss that point. Nothing you are going to see to-day will make any sense; but, as the surgeons write full notes on their ops., Sister Francis will only have to read their notes later, to know what went on. It is useful for the ward sister if she’s got an experienced pro. on the spot in an op., which is one of the reasons why you ward pros. come down; to get experienced, you’ve got to start coming down some time, though maybe not as soon as you and that other kid. She went flat out. Did you know that?’

  My stomach felt hollow. ‘No, Nurse.’

  ‘She did. So come over here.’ She opened the door of a small medicine cupboard. ‘Here’s the glucose and there’s the sal volatile. The dose is marked on both. Now, if the theatre starts revolving or you begin to sweat don’t try to stick it out, as this is your first visit. You can be a Spartan later, not at first. Doesn’t pay. So, if you do feel at all queer come out here quietly and help yourself to glucose and sal volatile. Then sit down and put your head between your knees.’ She smiled again. ‘Mind you, you may feel fine and not need a thing; but it saves everyone’s time if you know what to do, do it, and understand that we understand what you are doing. Don’t ask permission to leave for that ‒ just get out. We do try to avoid what happened with that other pro.; someone going out cold in the middle of a case is upsetting for the surgeons, and the person involved could fall across the table or hurt themselves badly going down. Luckily, I caught your colleague as she fell.’ She closed the cupboard door. ‘I’m afraid you haven’t got an easy case to start off with, but that can’t be helped.’

  ‘Is Roberts a difficult case, Nurse?’

  She hesitated. ‘Not so much difficult as long. Mr Waring is a quick surgeon, but I doubt if even he will do your man in under an hour and a half. Maybe longer. And that’s a long time,’ she added sympathetically, ‘in which to stand still in a hot theatre if you’ve never stood in one before. We have to keep the temperature up for the patient’s sake and we are used to working in a heat-wave temperature; you aren’t. But you will be. Very soon.’

  It was very hot in the theatre, and Roberts’s operation did seem to take a very long time. So long that I half wondered if the hands of the theatre clock had stuck. My ankles ached; my back ached; my head felt hot; my hands cold; but otherwise I was all right. I was far too interested in what was going on on the table to have any thought of fainting.

  I watched the steady, neat brown hands of the surgeons, and admired the tele
pathic partnership that existed between the S.S.O. and Sister Theatre. He never had to ask for anything. Sister anticipated his every need; each time he stretched out his hand in the direction of her trolley and her own gloved hand laid in his palm the right instrument he murmured, ‘Thank you, Sister,’ without once looking up from the wound. Once only he stopped momentarily, straightened his back, and flexed his shoulder muscles. He glanced at Sister. ‘Right?’ he queried softly of no one in particular. Then he bent forward over the table again; the two house-surgeons assisting stood poised, their heads tilted slightly to one side; neither of them spoke a word.

  The anaesthetist looked up, ‘All right this end, sir.’ The S.S.O. nodded slightly without looking round; Sister Theatre shifted her position slightly and peered over his shoulder, while in the galleries the students came closer to the glass walls.

  The bright white lights shone brilliantly on the white figures of the staff and the still, white-covered figure of the man on the table. There were only four colours in that theatre: white; silver; green; and scarlet. The gowns and caps were white, and so were the towels; the instruments and bowls were silvered; the oxygen cylinders green; and the rubber mackintosh on the floor was scarlet. There was no blood anywhere that I could see. I could not believe that that wound was on a man; I could see only instruments.

  It was some time later that the S.S.O. said, ‘Right,’ again. This time there was no query in his tone. The atmosphere in the theatre changed, and in the galleries the students sat back and talked quietly to each other.

  Shortly after, the anaesthetist said, ‘Time to send for the next chap, Sister.’ I looked at the clock. It was an hour and three-quarters since the unconscious body of Roberts had been wheeled into the theatre.

  The S.S.O. walked to one of the sinks and peeled off his gloves. ‘Where’s the ward nurse?’

  Sister Theatre nodded to me. ‘Behind you, Mr Waring,’ she told him.

  He turned, untying his gown as he did so. ‘Nurse, this is what I want done for Roberts when you take him back to the ward.’ And he reeled off a long, detailed list of instructions. ‘Will you repeat all that to Sister Francis with my compliments, please.’

  Sister Theatre interposed quickly, ‘Mr Waring, Nurse is new to the theatre. Shall I send one of my nurses back with your instructions?’

  He looked at her and then at me. Only my eyes were visible, so I doubted that he recognized me. I noticed his eyes for the first time. They were grey. Not steel grey, but the deep blue-grey of the English Channel on a winter’s day. They looked as cold as the sea and as uncompromising as winter at that moment, and the whiteness of his mask accentuated their colour.

  He asked briefly, ‘What have I said, Nurse?’

  I hesitated. I did not understand quite what he meant. Was this his way of telling me to go back to Francis?

  ‘Nurse,’ he said drily, ‘time may be immaterial to you, but I am afraid it is not so to this theatre. We have three more cases on the list. So would you be good enough to repeat what I have just told you?’

  For the second time in my short nursing career I was grateful for my ability to ape a parrot. I did as he requested.

  When I had finished he gave a slight nod, then turned his back on me, and began scrubbing his arms at the sink. ‘All right with you if Roberts goes back, Thomas?’ he called over his shoulder to the anaesthetist.

  ‘He can travel, sir. He’s coming along nicely.’

  Sister Theatre told me to take Roberts back to Francis. As we left the theatre the S.S.O. asked, ‘Who’s the next chap, Sister? Evans, isn’t it?’

  I went back to Francis Adams with Roberts, delivered the S.S.O.’s instructions to Sister Francis, took over from Josephine, who had escorted Evans as far as the anaesthetic room. Evans’s operation was a short one; the two men following him were also minor cases. While the last man was being operated upon I took my first proper look round the theatre. I felt an old hand by then and very pleased with myself. I had had no lunch and no tea, but I felt splendid. I wondered if I would like to be a theatre nurse. Or even a Theatre Sister. Might be rather fun. Certainly be exciting. I closed my eyes at the thought of working smoothly with the S.S.O. ‒ and there I made a mistake. A big mistake. I opened my eyes and blinked rapidly. The theatre started to revolve around me. I closed my eyes again; the darkness swam; I reopened them, and the theatre floor loomed upward, as though about to hit me in the face. I was standing only a few feet from the door; those feet lengthened into endless yards as I dragged myself to that door. Once outside, I leant momentarily against the wall. That did not improve matters. I knew I must sit down, and quickly. Now, where was that changing-room? Second door left ‒ or right?

  The theatre staff nurse put her head round the theatre door. ‘Bit too much, Nurse? Bad luck. Go down to the changing-room and do what I told you. Don’t worry about your man. He’s done now, and, as the list is over, I’m going to take him back to Francis for you. Wait in our room until I get back.’

  I said, ‘Thanks. Nurse ‒ please ‒ which way is ‒’ But she had vanished.

  I shook my head violently to see if that would clear it. It did, a little. The corridor was no longer spinning, merely revolving gently; I read some of the letters on the door opposite to where I was standing. The letters danced, but I read clearly ‘‒NGING ROOM.’ There was something wrong about their being there; I had thought she meant go down the corridor ‒ she must have meant across. Relieved, I stumbled over the corridor, reached the door, turned the handle, and then as I opened the door the floor really did come up and hit me in the face.

  As it was coming up ‒ or I was going down ‒ I thought I heard someone say quickly, ‘Nurse! What are ‒?’ But I did not hear any more.

  There was a mist round me. A thick grey mist, and through the mist I could hear a drum beating. I could not understand why I should hear a drum, why I was in a mist, what I was doing.

  A man’s voice said quietly, ‘Take it easy, Nurse. Keep your head down a shade longer. You’re coming round from a faint. Take it easy,’ and I felt a firm hand pressing not ungently on my head as the voice added, ‘Right. You’ll do.’

  The mist began to clear and I recognized the drum-beat. It was the noise of my own arterial pulse in my temples. And then I recognized that ‘Right.’ I had heard it four times this afternoon. It was the S.S.O.’s way of saying he had things under control.

  I opened my eyes properly, saw who was sitting on that bench beside me, and wished I could faint again. I closed my eyes, but it was not any good. I was finished with that faint. But why of all the men in this hospital did he have to be the one to act guardian angel?

  He moved his hand from the back of my head and touched my wrist. ‘Better now. Good. Stay where you are and I’ll get you some sal volatile.’

  I half rose. ‘I’m ‒ fine ‒ thanks.’

  He put his hand on my shoulder and pushed me down. ‘Sit, Nurse, and do what you’re told.’

  I relaxed against the wall and watched him walk over to the cupboard. It seemed to me to be the wrong cupboard; the staff nurse had shown me a different one, but I did not like to say anything. I shut my eyes and left him to find it out for himself.

  He pushed a medicine glass into one of my hands a minute or so later. ‘Knock that back, Nurse.’

  ‘Thank you.’ I sipped the liquid; it had a horrible taste, so I swallowed it quickly.

  He smiled faintly at my involuntary grimace. ‘Revolting stuff, isn’t it?’ He took off his cap and pushed back his hair. ‘Your colour’s back, so, if you feel up to it, I think I should suggest you go.’

  I jumped off the bench. ‘Of course. Thank you. I’ll go back to Francis at once.’

  He said, ‘I think you would be better advised to go and wait in your changing-room, as the staff nurse suggested.’

  I stared at him and then at the room. And then I saw why the cupboard had been the wrong cupboard. It was in the wrong room.

  ‘This,’ I licked my dry lips,
‘isn’t the nurse’s changing-room?’

  He undid his mask with infuriating calm. ‘If it was I should not be here. And, since this is the surgeons’ room, I’m afraid, Nurse, you should not be in here. Which was the point of my suggesting that you left.’

  I did not know what my colour had been, but now it was puce. ‘I’m so sorry ‒ I’m afraid I wasn’t thinking ‒ that is ‒ I wasn’t looking where I was going.’ My voice tailed away lamely as I made for the door.

  He opened it for me with what I was certain was mock civility. ‘You appear to make a habit of the latter, Nurse. Possibly you should be more careful. If not, one of these days you may walk into something really serious.’ He looked me over as if I was an odd specimen under a microscope. ‘How do you feel?’

  I felt as if I wanted to cry. I said, Thank you very much, I felt fine.

  ‘Right.’ He nodded briefly, then closed the door between us. He had barely closed it when one of the theatre nurses bustled out of the theatre carrying a load of soiled linen. She stopped momentarily, ‘Hallo? You the pro. from Francis who was took queer? Lost your way?’ She jerked her head across the corridor. ‘That door over there, Nurse! Not the one behind you. Can’t you read, girl? If not, you’d better learn fast. No white woman is allowed to set foot in the surgeons’ room ‒ so watch out, as that’s the door behind you!’

  I said weakly, ‘Thank you, Nurse.’

  Her eyes smiled over her mask. ‘You’re welcome. Glad I ran into you before you caused a riot. Most of the men are still nattering to Sister in the theatre; but the S.S.O.’s come out, and ‒’ she glanced round, then lowered her voice ‒ ‘if there’s one thing that Jake Waring won’t have, it’s an infringement of his privacy. So just as well I caught you in time, eh?’

  I said, ‘Yes, Nurse ‒ just as well,’ and she trotted off towards the linen chute.

  I went across the corridor into the right room, sat down on a chair, and pulled off my turban. Now, what, I thought, do I do now? Apologize to someone? And far more important ‒ what’s he going to do? Complain to Sister Theatre? Sister Francis? I thought of Bennings’s comments in that eventuality and shuddered. Even Matron? I decided I would rather face Matron than Bennings; Matron had better manners.