Although, sadly, things are a little different these days. Since 2004 there have been many more students to a body, up from four to twelve, and a lot of the time they come pre-dissected. It’s all supposed to save money, as looking after these bodies is expensive, but it does mean that students have much less hands-on experience than they used to.
‘I wonder why she became a drugs rep,’ I whisper. ‘She was actually quite good.’
‘Oh, that’s easy,’ says Steve. ‘She gets her own car, phone, and quite a lot of cash. Meanwhile, we have to scrabble around hoping for some spare egg sandwiches.’
‘Mmm,’ I say, biting into my fourth sandwich.
Karen carries on telling a room full of bored digesting doctors about the marvellousness of a drug they already prescribe while I try to work out how I might get Louise’s telephone number by the end of my shift. Or is she really having an affair with Chris? I’ve only got four hours left in the place to find out. I had better get cracking.
2–3 p.m.
I stay behind for a few minutes after the talk to have a chat with Karen. All I learn is that she is really happy, doing really well, is really happily married, has a really nice baby, and is earning seven grand a year more than me and working half the bloody hours. So I am really glad I hung around to ask all those helpful questions. I did also witness Steve scrabbling around and pocketing three free pens, which somehow added to my feelings of underachieving inadequacy.
How can she be earning £7,000 more than me? I pace along the corridor towards the door. I really need a cigarette. I am on a basic of about £30K for a forty-hour week, and with overtime and the bit extra I get for working at the coalface of humanity I can usually get it up to about £42,000. And that’s for getting shouted at, puked on and covered in blood for over ten hours a day. While she swans around in her Mini Cooper, chatting about statins and handing out free sandwiches.
Outside, I light my cigarette and lean against the redbrick wall.
‘Back again?’ comes a familiar voice.
‘And you,’ I say to Mary, who’s halfway down her Consulate. ‘All OK up there?’
‘Not bad,’ she says, fluffing up her red hair. ‘Marsha has named her child Destiny.’
‘OK,’ I say. ‘That was quick.’
‘I know. Makes me wonder if she did know all along. And the dad’s turned up.’ She takes a long suck on her fag. ‘Fifteen years old, barely capable of tying his own shoelaces.’
‘Right.’
‘And he’s asking for a paternity test.’
‘What? I’m amazed he knows the word.’
‘I get the feeling he’s seen it on Jeremy Kyle or Trisha or something like that, and he didn’t actually use the word, he just said he knew his rights and he wanted a test.’
‘So, all sweetness and light in Maternity this afternoon!’
‘No more than usual,’ she smiles. ‘Anyway, I’m off out this afternoon. Doing my rounds.’
‘That should be nice,’ I say, looking up at a relatively blue sky. ‘A bit of fresh air.’
‘You say that,’ she says, ‘but I can’t say I enjoy trawling through all those estates knocking on doors. Don’t get me wrong, the people are nice enough, it’s just that all those flats are so small and shitty. Actually, they’re not really flats. They’re rooms that they’ve sub-let off some council tenant. So what should be a council house with two bedrooms now has something like five different families, one to a room, making about twenty people all living in a two-bed flat and some tosspot somewhere earning five hundred a month per family. It’s amazing. They’ve a bed but nothing to really sit on, maybe a sofa, but always, without fail, they have a plasma TV. I don’t know how or where they get one, but they’ve all got one. Nothing to eat, but they’ve got a plasma. Nowhere to sit, but they’ve got a plasma. It’s like the other thing I always see. Really expensive buggies – Bugaboos, that sort of thing.’
‘I’m not sure I know what they look like,’ I say.
‘Oh you know, Gwyneth Paltrow had one and now they’re what all the mums want. That’s what they spend their five-hundred-quid Surestart maternity grant on.’
‘What grant?’
‘After a certain stage in your pregnancy you get assessed and then you get given it, along with the hundred-and-ninety-quid Health and Pregnancy grant that everyone gets.’
‘What? And they spend all that money at once on a pushchair?’
‘Most of it,’ she says, taking a final drag before dropping the butt on the ground and crushing it with her foot. ‘Well, at least they’re spending it on the baby.’
‘God,’ I say, feeling depressed.
‘I have got very used to going into smelly crowded houses. There are always a lot of children living in these cramped conditions, which of course doesn’t help.’
‘It all sounds very Victorian to me.’
‘It is. Except for the Bugaboo and the plasma. The thing is, they have access to the healthcare system but no access to the welfare state. They’re mostly illegal. They don’t work, they can’t work. I’m not really sure how they survive.’
‘Aren’t you scared going down there?’
‘Most people are usually nice,’ Mary replies. ‘I am, after all, a woman who is coming round to look at their baby. But I have seen some really shocking things. People do love their babies, but their ability to look after them …’ She shakes her head. ‘Last week I saw a baby with a bottle taped to its mouth. It was a tiny newborn, with all this Sellotape around its mouth; it could barely move or breathe. I wasn’t sure whether it was done out of laziness or just to shut it up. I did report that to Social Services. But, you know, it’s hard. Some people don’t have a clue.’
Mary goes on to tell me that some parents think they can start putting tea in the bottle after a couple of weeks. Give it some cow’s milk, maybe with a bit of flour in it to fill it up. This is one of the reasons why the government has upped the weaning age from four to six months, because people feed their kids so badly; they thought that if they kept babies on milk a little longer they might get a better start. Not that it makes much difference, apparently. All that happens is those who were going to feed their kids KFC still do, and those who were going to give them organic carrots wait that bit longer. Although two months is the average age at which the KFC brigade wean their babies. No wonder, then, that we have an obesity problem.
‘The people I deal with are so far removed from the people making the laws or coming up with these ideas and plans,’ Mary continues. ‘They think the rules don’t apply to them. They live completely outside society.’
‘And what are you doing this afternoon?’
‘Weighing, heel-prick tests, that sort of thing. Testing for sickle-cell anaemia. You know, the usual.’
‘I don’t envy you at all,’ I say, exhaling a plume of smoke into the sky.
‘Yeah, well, everyone has to be checked, even the mums who are completely white and don’t stand a chance of having sickle cell. You never know who the dad is.’
An estate car pulls up in front of us and a very large, very red-faced, puffing woman hauls herself slowly and gingerly out of the passenger seat. A rather more frantic-looking man/partner/husband has whipped out of the driving seat and is helping her. The woman leans against the car to catch her breath while the bloke scurries to the boot to pull out a suitcase, a bucket, another bag and a giant silver ball. Somehow he manages to carry or get hold of all these items and lock the car with his keys.
‘OK, darling,’ he says over the top of the silver ball, ‘can you walk?’
‘One minute.’ She huffs and pants and puffs and exhales. She is clearly riding quite a big contraction. ‘OK,’ she squeaks. ‘I think I can move now.’
‘If she’s not careful she’ll be a born-before-arrival in the car park,’ I say to Mary.
‘Either that or she’s about one centimetre dilated,’ Mary responds, looking the woman up and down as she and her man/partner/husband list their way to
wards the front doors of the hospital. ‘She’s got the whole NCT thing going.’
National Childbirth Trust women are famous for arriving with their balls, buckets and birth plans that usually involve scented oils, smelly candles and a lot of moaning, groaning and tantric massage. In my experience, with all this comes a deep distrust or, at best, wariness of hospitals in general. So they are also prone to cleaning the birthing room from top to bottom as well as the lavatory, and some have been known to eschew the hospital’s clear plastic cribs for a brought-from-home Moses basket. Having read every book on the subject of birth and having also got intimately in touch with themselves doing yoga, they can also be very dismissive of us lot. I remember one couple telling Julian off for checking the heart monitor, telling him to stop bothering them, like he was some desperate pregnancy perv gagging to be in the room with them or something.
These guys seem to have drawn the line at the Moses basket but they have all the other NCT paraphernalia, including what looks like an iPod for the inevitable pan pipes, whale noises or World Music collection.
‘She’ll be demanding an epidural in about half an hour,’ says Mary. ‘I’d better get out of here before I have to get PC Patsy over there a great big shot of pethidine.’
‘I thought that was banned.’
‘It is.’
‘I always thought it was strange to tell women that they’re not allowed to drink during pregnancy only to whack the baby with a whole load of opiates just as it comes into the world, leaving it too stoned to breastfeed. Although I could think of worse ways to arrive.’
‘True.’ She smiles. ‘See you later.’
‘Good luck,’ I say. ‘I may not see you before I go. I’m leaving today.’
‘Of course.’ She nods. ‘Black Wednesday tomorrow.’ She gives a little shiver. ‘I’ll see you around.’ She gives me a wave and walks off.
Back in A&E, all the cubicles and most of the private rooms are full. The majority of the curtains are closed but I can see a young bloke dressed in tennis gear with some sort of twist or break to his ankle. Opposite him is a middle-aged woman in a floral frock sitting up reading Hello! She’s flicking through the pages like she’s waiting for a pedicure at a beauty salon. She is waiting, it transpires, after I ask Andrea, for a repeat prescription for HRT. Hardly an A&E problem, but apparently her doctor’s on holiday and she’s desperate.
Over at the far end there seems to be a bit of a queue for the computer. Jon Berry doesn’t appear to want to move his skinny pre-pubescent arse from the area, and he’s been joined by someone else.
‘Who the hell is that?’ I ask Ian, who is ambling past with a fist full of bloods.
‘Oh Christ,’ he says, rolling his small bloodshot eyes. ‘It’s another one of those tosspots.’
I continue to look quizzical. ‘That doesn’t narrow it down.’
‘Oh you know, a tosspot, a management consultant – from Accenture or McKinsey or wherever.’
‘What? Another person’s been sent to scrabble around and try to find more bloody cuts and shavings?’
‘It’s like inviting vampires to the blood bank,’ says Ian.
‘It would help if they actually spoke to the staff,’ I suggest.
‘No one asks us anything!’ says Ian. ‘It’s the NHS!’
Too true. No one ever asks our opinion on anything. Just a thought, but perhaps they should have chatted to a few doctors before embarking on the multi-billion-pound overhaul of our computer system, instead of giving the go-ahead to the programme after what was a ‘sofa meeting’ without any consultation with doctors or any other members of staff about what might be useful, practical or indeed helpful in some way. Instead, the government blithely went ahead and embarked on the largest non-military IT project in the world, at a cost of £12.7 billion, only for it to fall flat on its face some eight years later, having cost us over £400 million. Think of the beds and drugs and man hours that figure equates to. But, you know, what’s a few billion when you have a grand scheme to accomplish?
Then again, waste is the order of the day in a monolith like the NHS. It’s the boring things that are annoying when you work here. Sterilized swabs only coming in packs of five, so you use two and have to throw the rest away. Scissors that are only used once before they too must be discarded, when they could be sterilized and reused. Drugs coming in the wrong packets and sizes. I am forever opening vials of lidnocaine, a local anaesthetic, using one-tenth of it, and throwing the rest away. But what are you supposed to do? The organization is so huge that the idea of catering to individuals is too expensive. It’s like working in some old Soviet factory where it’s easier to keep the gas burner burning all day rather than turn it on and off, because they have run out of matches. It’s the same logic in the NHS. It’s too difficult to sterilize a pair of scissors so let’s just use them once then chuck them in the bin.
Talking of waste, I suddenly notice Mr Lee sitting bolt upright in Andrea’s office. His briefcase is resting on the desk next to the chocolates, and he’s staring expectantly at the door.
‘What’s happening with Mr Lee?’ I ask Ian, before he wanders off.
‘Oh, I know,’ he replies. ‘Poor sod, I think they’re trying to find some sort of use for him. Andrea’s on the case. They are after a position where he doesn’t have to talk to patients or interact very much at all.’
‘Pathology?’ I suggest.
‘Or the morgue. There are always openings in the morgue.’
‘He could always earn a living translating for patients on the ward. D’you remember that other Chinese doctor we had who was discovered moonlighting as a translator on the wards?’
‘I think that requires you to have at least a rudimentary grasp of English,’ suggests Ian.
‘Oh yeah.’ My brain is very slow today. ‘I’d better go and check up on a patient.’
‘Your hip woman is still in the corridor,’ he says as he walks off.
Shit! June! I presumed she’d been taken care of hours ago. Last I heard, Margaret was looking for an orthopod to check her hip and she’d been sent for an X-ray.
I open the corridor door to find her lying there, looking very stiff and grey. Her X-ray results are sitting on the end of her bed, but no one had told me they were back, or that the consultant had not arrived. I feel awful. Not as awful as her, obviously. But awful just the same.
‘Hello, June,’ I say, ‘I am so sorry you’ve been left here. How are you?’
Her face slowly turns to look at me. She looks terrible, like she is in a lot of pain and has been for some time. I check her IV and her fluids bag is empty. Shit. What the hell is going on here? While the rest of us have been chasing our own arses next door, June has been lying here in agony and no one has noticed.
‘I don’t feel terribly well,’ she says. Her eyes are looking a little cloudy. She is probably dehydrated and needs a strong painkiller right away. ‘I think I would like to see a priest.’
‘A priest? Really, June, I don’t think it has come to that,’ I say, trying to be jolly as I take hold of her wrist. It feels floppy, and her pulse is weak. I can feel my own pulse increasing rapidly. This is not just your usual dehydration. ‘I’ll just go and get a nurse.’
‘Don’t leave me,’ she says, her voice sounding very feeble indeed.
‘I’ll be back in a minute, I promise.’
I march straight back into A&E, throwing back the doors. Andrea stands and stares at me like I’m some melodramatic thesp on the set of ER.
‘All right, sunshine?’ she says, somewhat disparagingly.
‘No, I am not. I have a patient in her seventies who might be dying in the corridor.’ I want to scream but I manage to control myself, so my words come out as some sort of quiet, spitting rage.
‘What, out there?’ Andrea says, seeing Daily Mail headlines flash up before her.
I have never seen such a short, large woman shift so quickly in my life. Before I can turn round to follow her she’s through t
he door and by June’s side, assessing the situation.
‘All right, dear?’ she says, tapping the back of June’s hand. ‘How are you?’
June is so weak that she can’t be bothered to castigate Andrea for her slow, patronizing question, like she did with me when she first came in. The fight is going out of her. Where are her children? I pump back up the IV and hope that the drugs might make her feel a bit better.
‘I would like to see a priest,’ says June, quietly but clearly. ‘As soon as possible, please.’
I look at Andrea and she looks at me. We both know that this is not looking good. Or at least June is not looking good. We have a prayer room in the hospital, which is multi-denominational, and we have a chaplain who visits the wards on a Thursday, I think it is. And he does sometimes give Holy Communion to those who want it. But we are at the heart of a big city and we all live much more secular lives. We don’t have a priest on tap to talk to the sick or dying.
‘I’m going to get Ian and Chris Williams,’ I announce.
‘And I’ll stay right here,’ says Andrea, squeezing June’s ever more feeble hand.
It takes another ten minutes for June to die. She never did get her priest. What she got was Ian tap-dancing on her chest, trying to massage her heart back into action. She got armfuls of adrenalin, she got Chris shouting out orders left and right, and she got nurses struggling to get more lines into her narrow veins, jabbing away at her tissue-thin skin. It was not a quiet death and it was not dignified. It was a mad scramble to the end, with everyone trying their best to eke out another few days, weeks or even months for June. Most of all, no one wanted her to die here. On our watch. Of a heart attack. Andrea and Chris are worried about their statistics. We have on average about five deaths a week here. We’re on target this week as June is the first death so far and it’s already Tuesday.
Hospital Babylon Page 9
