‘Hello, Mr Berry,’ says Margaret, her hair glistening in the neon strip light.
‘Please, call me Jon,’ he says, rocking back and forth on the thick soles of his Hush Puppies.
‘OK then, Jon,’ says Margaret, clawing back some dignity. ‘Let’s start with the A&E waiting room.’
Margaret escorts the suited Jon Berry down the corridor.
‘He looks about fourteen,’ says Chris, sounding deeply depressed. ‘Well, he can’t be any worse than that last woman.’
The ‘last woman’ was a total cow with a penchant for megalomania. She would march up and down the corridor in her power suit, with her power shoes, sporting her power specs, issue orders while waving a clipboard and demand to know why this patient was sitting on a trolley in the corridor, or why that patient was still waiting after four and a half hours. What we wanted to do was shout in her power ear that we were ‘too fucking short-staffed’ or ‘too fucking busy’ and ‘if we could fucking do something about it we fucking would’. Obviously we would have ended up the subject of some sort of disciplinary action, in some sort of committee room. So we lied. Not great big porkie pies. Just little ones. We didn’t exactly hide patients from her but just fibbed about how long they had been waiting, and what they were waiting for. ‘Waiting for a chest X-ray’ was one of my favourites. That usually got rid of her for an hour, before she’d trot back on her high horse looking to find fault.
We took a bit of badgering initially. We were all keen to improve the department and up our stats. But then we’d get memos like the one that complained we were spending too much money on ‘staffing, consumables and drugs’. We were a hospital that was spending too much on doctors, nurses and things that make people better! Unbelievable. She then asked Andrea to write a report to the director of operations to explain why our deaths per week were up and our performance had dropped since October. She was given one hour to write it, which seemed a little unprofessional, and indeed unfair.
But management just loves to tick a box or fill in a form. The four-hour A&E waiting time edict just means that there are a lot of patients admitted into the hospital who shouldn’t be there. Better to shove them on a ward somewhere to get them out of the way and then if we are really smart we can process them and get them out again within twenty-three hours, so another target is hit: people who spend less than a day in hospital. Who cares if they spend another six hours in the ‘discharge lounge’, just so long as we can use their still-warm bed? Or indeed another five hours sitting in the hospital pharmacy waiting for their take-home meds? We’ve hit all our targets. The government will be ever so pleased and we can have some more money. And woe betide any hospital that gets a surgeon or a physician who is a maverick genius. What the system wants is doctors or surgeons who go nicely down their lists and clear their decks and keep as few people waiting as possible. The problem with the genius doctors is that they attract more ‘clients’, or patients; people start choosing to come to your hospital, and then you are in all sorts of trouble. Your waiting lists grow longer and your stats go down. No, no, no, talent, flair and brilliance are absolutely not to be encouraged.
‘I hope he’s got a better degree than her, though,’ adds Chris as he turns to go back and check on his burns patient. ‘She had a two-two in business administration from Kettering University. And you,’ he says to Steve, ‘had better put your scrubs on. You’re due on at ten a.m.’
I follow Steve along the corridor, as I am now desperate for my bacon sandwich. The fact that it will be not only cold but congealed now is only adding to its allure, I am that goddamn hungry.
‘D’you think I got away with that?’ asks Steve.
‘What, morally, emotionally? Or, did Chris clock what was going on?’
‘Mr Williams, of course.’
‘Don’t think he saw anything.’
‘Really?’
‘Not that I noticed,’ I say.
‘Excellent,’ sniffs Steve. ‘Maggie’s been promising me one for the last six months and, you know, last day and all that …’
‘Carpe diem, mate, carpe diem,’ I say, heading off to the common room and my sandwich.
‘My thoughts exactly,’ he says, going into the changing room.
The common room is already filling up with the detritus of the day. There are crisp packets on the floor, sweet papers on the chairs, and the air has that slightly sweet, cloying smell of McDonald’s chips. I look around on the windowsill for my bacon sandwich but it seems to have disappeared. Shit! I check the next-door windowsill and the floor around it just in case someone’s knocked it off. Shit! It’s been pinched. Either that or thrown away. But no one clears up this place, least of all the cleaners. About once a month the fridge gets emptied of all the rotting half-eaten packed lunches, but that’s only for health and safety reasons. No one would tidy up a sandwich.
I am livid. I can feel a wave of indignity and injustice rising in me. My stomach grumbles with self-pity. Two can play at the game, I think, striding towards the fridge. I check in the door. Quite frankly, anything that is in the fridge door is fair game. Everyone knows that. You would have to be an idiot, or new, to put anything unopened in the door. Oh my God, joy of joys! Half a KitKat! I grab the two fingers with both hands, shove them straight in, and make a very sharp exit.
With my cheeks fuller than a hamster preparing for a famine, I walk back out into the corridor and bump slap-bang into Andy, an anaesthetist who has a bit of a charm-bypass problem.
‘All right?’ he asks. ‘I hear you made a bit of a dick of yourself last night.’
Andy is typical of a myriad of anaesthetists who appear to follow the ABCD rule as they attend a crash call. They Arrive, Bitch, Criticize, then Depart. The theory is that because all they ever really have to worry about is their tray of syringes and what order to use them in – big syringe, little syringe, or little syringe, big syringe? – they have plenty of time to stick their long noses into other people’s business. And if they aren’t bitching, they are sitting on their gas tanks doing the Times crossword, or sudoku, depending on their age. There are a few of them who are quite cool; after all, they are experts on using all sorts of drugs from opiates to mind-bending hallucinogens, and they get paid £100,000 a year for their trouble. But it is an odd job – 90 per cent boredom, 10 per cent life-threatening fear – and it does seem to attract quite an odd bunch of people. Most of them choose it as their specialism because you have a regular lifestyle, others because they have an OCD about achieving the perfect take-off and landing – i.e. the perfect way to put someone to sleep and wake them up again. But there are others, like Andy, who do it because they are dull twunts with no bedside manner at all.
‘Really?’ I say, slightly wanting to kick him in the blue-scrubbed nuts. ‘What did you hear?’
‘That you were dancing in a wig,’ he sniggers.
‘Right.’
‘And that you were really drunk,’ he adds, for good measure.
‘At least I wasn’t sitting on my own with a Diet Coke.’
‘I had to work today,’ he says defensively.
‘And I am here for my health.’ I start to walk away.
‘Ha ha,’ he says. ‘But some of us take our jobs seriously.’
‘Go and put someone to sleep, Andy. Actually, why don’t you talk to them and save yourself some drugs?’
‘Did you hear Louise was caught in a linen cupboard with Mr Williams?’ he declares.
I stop in my tracks.
‘There!’ he says. ‘That woke you up!’
‘Don’t believe you.’
‘Ask her yourself, seeing as you two are such good mates!’ And with that he walks off in the direction of the operating theatre.
Louise? And Mr Williams? Chris? But he’s married. Second wife, I grant you. And he has four children. Surgeons always have lots of children. I’m not sure if it’s because they live such a visceral existence, or they think their genes need to be replicated as much as possible. I
met a surgeon once who proudly announced that his genes were so goddamn marvellous that he needed to have three children with three different wives. (God administered a certain cruel justice in the end: his third wife had twins and he was taken out by a massive stroke soon after they were born.) Typical surgeon behaviour – all about targets.
‘Oh there you are,’ says Louise, running up to me in the corridor.
‘Sorry,’ I say, rather embarrassed at being busted thinking about her sex life. ‘Um, how can I help you?’
‘Please don’t be cross,’ she says, smiling sweetly and ruffling her short dark hair. ‘But I told Mr Williams you would do it.’
‘Do what?’
‘You were so good at the last one.’
‘Which last one?’
‘There’s a poor bloke in there with priapism.’
My heart sinks.
‘He is best man at a wedding at two p.m. and he’s desperate. He has tried water, ice, Ann Widdecombe …’ She smiles again.
‘Go on then,’ I say. ‘You may as well just call me Dr Cock.’
‘Actually, Mr Cock, seeing as you’re a surgeon,’ she says, linking her arm in mine and walking up the corridor with me. ‘And can I just warn you, it is enormous!’
10–11 a.m.
Louise is not joking. It is not the largest I have seen by a long way, but the bloke is certainly gifted. And, of course, mortified. Priapism is caused by many things – neurological dysfunction, spinal cord lesions, even reactions to drugs or a spider bite – but the most common reasons are sickle cell anaemia and Viagra.
We have had a few Viagra overdoses in recently. Most were treatable. Even when one of our paediatric surgeons came in after a heavy weekend with his wife, we mostly managed to treat the penis by sticking a needle in it and aspirating away the blood. But we had one bloke in a few months ago which was a complete disaster. His girlfriend had gone away for a week and he had shipped in a whole load of Viagra and an extracurricular girl. I’m not sure if she was a prostitute or another girlfriend, all I know is that she didn’t stick around to witness the fallout. Anyway, his erection didn’t go down after the weekend. I’m not sure if it was because he was embarrassed per se or whether it was guilt about being unfaithful that stopped him coming in. But he didn’t come in until the Wednesday, which was a huge mistake. By the time he got to us, his penis had turned black. It was black and rock hard. The blood that was stuck in the end of it had congealed and hardened. His cock was effectively dead. We tried to massage the thing, cannulate it, fill it full of fluid, revive it in any way, but that was it. It was solid and therefore dead. So the girlfriend came back after a week of being away to find out that not only had her boyfriend been unfaithful, he had lost his cock in the process.
Fortunately, this bloke has only had an erection since about seven this morning, he doesn’t have sickle cell anaemia, and neither has he been using Viagra. However, that does not make him any less desperate. Going through his notes and talking to him, it transpires that he has suffered from the condition before, and it tends to get worse when he is nervous. Obviously being best man this afternoon has brought the condition on. I offer him a drug to help bring the problem under control but it will be too slow-acting for him to make the wedding. He even contemplates going to the service and then coming back to hospital before the reception, but his trousers and boxer shorts can’t contain his ‘excitement’ and it is extremely obvious what is going on. So he looks at me and I look at him and then he says, ‘Go on, doc, do your worst.’ I explain to him that a nurse and I will each put a large needle into the shaft and attempt to take out as much blood as we can, to see if we can make the thing go down. I have to say his face falls a little when he sees Andrea arrive, from behind the curtains, bearing a syringe. Despite the local anaesthetic he screams the place down – which is not that helpful when you have a room full of patients waiting. Then again, you can hardly blame him. It has to be one of our more painful procedures.
It does the trick, though. Ten minutes later he is all smiles and hugs as he gets back into his clothes and sprints off to pick up his morning suit.
Back at the computer, I am standing next to Chris Williams waiting for Jon Berry to finish whatever important bit of ‘management’ he is doing.
‘How long was Mr Johnson waiting?’ Jon Berry asks over the top of his short sweaty nose.
‘Who?’ I ask.
‘Your last patient?’
‘The one with the huge erection?’ I say, to wind him up a little. I can see Chris smiling behind him.
‘That’s the one,’ Jon Berry responds, completely unfazed.
‘Forty-two minutes.’
‘Excellent,’ he says, typing away.
Chris gives me a quizzical look and I shrug back. It was a figure I plucked from nowhere. He wasn’t my patient, he was Louise’s; she clicked on him on the computer. But the number sounded plausible and, most importantly, very efficient.
‘Talking of cocks,’ injects Chris – which we weren’t – ‘did you hear what happened last week at the Orthopaedic Surgeons Golf Dinner?’
‘No?’ I say. ‘And anyway, what were you doing there?’
‘My mate Jeff is getting divorced and I play off twelve, so I was his plus one.’
‘Is that good?’ I ask.
‘Very. Don’t you play golf?’ Chris sounds somewhat incredulous.
‘No.’
‘How are you going to get on!’ It was more of a statement than a question.
I look a little uncomfortable. Clearly, being a good surgeon is not enough.
‘Anyway,’ continues Chris, ‘there’s this one orthopod who had a sex change, the whole thing, the full penis-off, man-in-a-boat exchange—’
‘Man in a boat?’ asks Jon Berry.
‘A clitoris, man, a clitoris!’ says Chris, irritated at the interruption. ‘He was married, you know, two children. Anyway, that’s not a problem. If a man wants to be a woman, then good luck to him. No. What really pissed us all off was that he teed off with the ladies. I mean, the balls of it! Or, indeed, lack of. But, really! He won, obviously. Quite ruined everyone’s afternoon.’
‘I can imagine,’ I say, trying my hardest to empathize.
Jon Berry just sits there, typing away, his ears throbbing red with embarrassment.
‘Is the new doctor here yet?’ Chris interjects suddenly by way of covering the silence.
I look at him blankly.
‘Mr Lee. The one from China, he is supposed to be arriving today? He should be here by now.’
We both look back past the computer and into A&E. The place is buzzing. Most of the cubicles are occupied, there are nurses bustling briskly to and fro, Steve is helping an elderly woman who appears to have a large bruise on her head into a chair, Louise has a fistful of bloods and is making her way over to the chute, Ewan looks to have his hands full with some screaming child and his equally uncooperative mother, Margaret’s hair is a little less shiny as she wheels an IV stand across the corridor, and Andrea is standing by her office door, chewing a toffee, guarding her chocolates.
‘I can’t see him,’ I say.
‘Yes, well,’ says Chris. ‘Tell me if you do. And come and get me when Buggerlugs here is off the computer.’
‘You can’t call me that,’ says Jon Berry, indignantly.
‘So sack me!’ says Chris, walking away.
‘One surgeon was fired recently for putting extra croutons on his salad and not paying for them,’ replies Jon Berry, by way of a weak threat.
‘I never eat in the canteen,’ retorts Chris, before disappearing behind a pistachio curtain.
I am just about to check with Andrea that June, with the broken hip, has been taken off to X-ray – as her cubicle now appears to be empty – and if they have room for her upstairs, when I spot Mr Lee wandering into the department. Short, definitely under five foot, he has thick specs and an even thicker girth. He is smiling broadly – I’m not sure whether out of friendliness or bewilde
rment.
‘Mr Lee!’ I say, walking towards him with my hand outstretched. ‘Welcome to A&E!’
He smiles at me and hesitantly takes my hand. I shake it. He shakes back and bows his head slightly, muttering under his breath.
‘You stay there and I’ll go and find Mr Williams for you.’
He smiles at me again and I smile back and walk off to find out which pistachio curtain Mr Williams is hiding behind. Mr Lee follows me. I interrupt Ewan looking down the mouth of his moaning child. In the next cubicle I find Chris shining a torch into the eyes of a man who has been splashed in the face with some unpleasant chemical at work.
‘I am sorry to interrupt,’ I begin, ‘but Mr Lee is here.’
‘Excellent, excellent,’ says Chris, peeling back the poor bloke’s eyelids just that bit further. ‘You seem to be OK. I’ll get one of the nurses to give them a rinse, then we’ll get you a nice cream to dull the pain for a few days, and you should be fine.’ Chris squeezes the bloke’s shoulder and he smiles appreciatively. ‘Ah! Now, Mr Lee!’ he exclaims, turning around to shake the doctor’s hand. ‘How are you? How was your journey? When did you arrive?’
Chris fires off questions as he ushers the diminutive Mr Lee down the corridor away from the patients and towards Andrea’s office and the computer desk. Mr Lee nods away and smiles at everything. By the time Chris reaches the desk it begins to dawn on both him and me that Mr Lee has not answered a single question or even uttered a word. Chris pauses and runs his hands through his grey temple hair.
‘Um, Mr Lee, I hope you don’t mind me asking …’
Mr Lee nods.
‘Can you actually speak any English?’
We all look down at the tiny bloke, who looks back up at us, and smiles again. ‘Chinese,’ he says, finally. ‘Chinese.’
‘English?’ asks Chris.
‘Oh.’ He nods. ‘Google translate.’
‘Google translate?’ asks Chris.
‘Google translate,’ he confirms.
‘But I have been emailing the man for months,’ says Chris. ‘Asking him questions, saying that we were looking forward to having him in the department, sharing our knowledge and all that jazz, and he has replied in perfect English every time.’
Hospital Babylon Page 4
