Hospital Babylon

by Imogen Edwards-Jones

  But you know, sometimes we manage to turn things around. Sometimes even the most determined suicide attempt can be thwarted. I remember Louise telling me about a bloke who swallowed two litres of vodka, knocked back umpteen paracetamol and Prozac, and slit his wrists before getting into a car to drive to Beachy Head. He clearly meant to kill himself. Unfortunately (or fortunately) for him, he bled so much that his blood pressure dropped and he passed out at the wheel. He came to A&E as an RTA (road traffic accident) rather than an attempted suicide and was completely furious when we revived him. He’d had a row with his wife and wanted to finish it. Amazingly, the wife came to his bedside and they made up. They left together a few days later. He was apparently very grateful for this second chance.

  I wonder how pleased Katie will be when she comes completely to.

  A very slim, mousy-looking woman pokes her head around the curtains. ‘Is she OK? I’m her mother.’

  ‘She’s fine,’ I smile, covering up the wound with a swab. ‘She’s lost a bit of blood, but—’

  ‘I do wish she would stop doing this,’ Katie’s mother says, mincing her thin pale hands. ‘I blame her boyfriend. She hasn’t been the same since she hooked up with him. She was good at school, you know, and was going to university until he came along, and now look.’

  ‘Mum? Mum?’ Katie moans, and rolls about on the bed. ‘Go away, Mum. Why don’t you go away?’

  ‘It’s your own fault all this!’ the mother snaps. ‘Told you that Danny wasn’t good enough for you!’

  ‘Go away, Mum.’

  ‘No, I won’t! Not until I have had my say!’

  ‘Mum! Go away!’

  ‘Um, perhaps it’s better if you wait through there,’ I say.

  ‘Are you trying to get rid of me?’ She looks at me, her top lip slightly curled to reveal a set of yellow rat teeth.

  ‘I just think it would be better if you waited through there while I stitch up Katie and you can perhaps calm down a bit and then come back when she might be more ready for visitors.’

  ‘I am not a visitor! I am her mother!’

  ‘I know, I know,’ I say, staring at Connie, urging her to do something.

  ‘Would you like a cup of tea?’ asks Connie, walking forward and putting her arm around the mother.

  ‘A cup of tea?’ She looks a little suspicious.

  ‘Yes. With milk and sugar.’

  Connie escorts the woman out of the cubicle and the tension dissipates.

  Katie doesn’t say a word while I stitch her up. She doesn’t offer any explanation, and I don’t bother to ask. I have had quite a day and am really looking forward to putting my feet up this evening and perhaps having some dinner with my girlfriend Emma. I’m hungry. Pizza would be nice. I put the finishing touches to Katie’s bandage. She doesn’t smile or say thank you. She simply rolls over and faces the wall. I hope the psych team get more out of her when they turn up.

  Outside in the corridor there has been a change of shift for the SO19 officers. We have two new blokes wandering around A&E, cluttering up the area. I think two of our gangsters have been transferred to private rooms upstairs, which seems an ironic reward for bad behaviour. We only have one bloke left down here, awaiting transfer.

  Chris is walking towards me; his face is a little drawn. I glance across at the door to the private room where June’s daughter was sitting. It’s open. A large box of chocolates and a bunch of pink peonies lie abandoned on a chair.

  ‘How did she take it?’ I ask, still staring at the flowers.

  ‘Not well,’ says Chris. ‘She says she wants an inquiry, but I don’t think she means it.’

  ‘Really?’

  I feel my heart racing a little, even though I know I did nothing wrong. Her mother may have lain in a corridor for a little too long, and she may have run out of fluids, but it wasn’t actually my fault that she died. Heart failure due to the combination of stress from the fracture and the drugs is just one of those things. It’s not something that we can predict or prevent. Then again, had I done something like given her too much morphine and plunged her into respiratory arrest, or given her too many fluids causing a heart attack, the results would have been similar. We look after our own in this hospital, so small mistakes, no matter how catastrophic, tend to … well, not exactly get brushed under the carpet, just not be highlighted exactly. If the mistakes are huge and catastrophic, the NHS will look after you. They won’t fight your battle for you, they won’t help you clear your name if it wasn’t your fault, but they will always cough up for you and they will always settle out of court. Given the prospect of a protracted and expensive court case, the NHS would rather give the plaintiff half a million quid and tell them where to go. Which is obviously great if you are a shit doctor who is actually negligent, but if you are a good doctor who is being hounded or pursued by a vindictive nutter and his family it is less good, as you never get your day in court and have to carry on with your career slightly tarnished.

  Of course there are some things, like a nurse killing several patients with an overdose of painkillers, that just can’t be brushed aside; and neither can things like the persistent neglect of a patient that caused him to die after he had to telephone the hospital’s switchboard begging for a glass of water, having been refused by a nurse. Then again some extraordinary stories, like a hospital porter having sex with patients as they were out cold on the trolley in the lift on their way to and from theatre, never see the light of day. This scandal was only unearthed after one of the patients became pregnant. Who knows how much the trust paid out then? Or how much it cost to put CCTV into all those lifts?

  ‘I’m sure she doesn’t mean it,’ Chris says, giving my arm a squeeze. ‘She’s just upset. In my experience, she will go home and talk it over and realize that there was nothing to be done.’

  ‘I hate it when that happens,’ I say.

  ‘I know.’ He nods. ‘So does that nice Mr Berry over there. Oh, by the way, have you seen our friend Mr Lee?’

  ‘No.’

  ‘That’s annoying. We’ve managed to find him something in Pathology but we just can’t seem to find him. His briefcase is still in the office.’

  ‘He can’t have gone far.’

  ‘Let’s hope not. Anyway, don’t worry,’ he says to me again, giving my shoulder a final squeeze before turning away.

  I am just summoning the energy to go and see another patient – I’m sure I can fit in a couple more before I leave tonight – when Steve walks over.

  ‘You look like you could do with cheering up,’ he says. ‘Follow me.’

  I don’t know why, but I follow him. It is true I could do with a laugh. He leads me through the double doors, along the corridor and off into the pre-med section just before theatre. Behind a curtain, lying on a trolley, anaesthetized to the world, is a young woman with dark brown hair. Beside her is Andy, sorting out his big syringe/little syringe combination.

  ‘Not you again!’ he says to Steve. ‘Sod off!’

  ‘You shouldn’t have showed me if you didn’t want me to share the joy,’ says Steve.

  ‘What?’ I say.

  ‘Take a look at this,’ he says.

  He lifts the bottom half of the woman’s gown to reveal a Snoopy tattoo just above the bikini line. The character is grinning, pushing a lawn mower, cutting her pubic hair ‘grass’.

  ‘Isn’t that magnificent?’

  5–6 p.m.

  Steve is going to get himself in real trouble one day. Undoubtedly Snoopy is very amusing, and if you are the sort of girl who puts a Snoopy tattoo just above your bush for comic effect then I’m pretty sure your intention is to have said tattoo admired and commented upon. However, I am also pretty sure that having your fanny sniggered at by five complete strangers while you are comatose and waiting to have your appendix cut out is not the kind of audience she’d envisaged. But I have only got an hour left in this place and I like Steve so I don’t really want to part on bad terms. He’s a good-looking bloke who wi
ll probably go far. I might need his help one day.

  Back in A&E, poor Mr Lee has finally been located wandering around the ground floor. We think he went to find the loo and got lost trying to find his way back to the department, although no one is quite sure. Anyway, Chris very charmingly takes him under his wing and escorts him over to the lift, leaving Andrea to take him up to Pathology on the fifth floor.

  ‘I wonder if we will ever see or hear of him again,’ he says, standing by the computer, waiting for Jon Berry to finish whatever he’s doing. ‘Excuse me,’ he says, scratching his greying hair in irritation, ‘how much longer are you going to be?’

  ‘I am just collating the waiting times for each patient today,’ says Jon. His little pinhead appears to wobble with self-importance. ‘And then we will combine the average with the other averages that have been gleaned over the past month and we can come up with a monthly average.’

  ‘Right,’ says Chris, inhaling with boredom. ‘And meanwhile, what are we, the people actually looking after patients, supposed to do?’

  ‘I’ll only be a minute,’ he says.

  ‘Shall I tell that to the child with a broken arm who’s been waiting over forty minutes already?’ says Chris.

  ‘I’ll only be a minute,’ Jon Berry repeats.

  ‘Why don’t you tell the administration manager or whatever the hell he is called these days that we need a few more computers down here – either that or a few less managers.’ With that, Chris turns round to march off and walks slap-bang into the management consultant from Accenture, or wherever. ‘And what are you doing here?’

  ‘I’m observing,’ he replies.

  ‘Observing what? Six people waiting to use a computer? Observing the observer observing someone else, who might actually be doing something if you lot weren’t in his way?’

  Chris is very obviously about to lose his temper, but he is suddenly distracted by the arrival of a rather dapper-looking member of the rapid response psych team.

  ‘Nigel Andrews!’ he exclaims. ‘How the very hell are you? I didn’t expect to see you down here.’

  ‘Yes, well, I didn’t expect to be down here,’ says Nigel, a well-kept fiftysomething with thin blond hair that is neatly parted on the right and combed over to the left, attempting to disguise a rather shiny pink bald head. He is wearing a crisp white shirt, a pale patterned silk tie and a very smart, well-cut navy blue suit that whiffs of a prosperous private practice.

  ‘I haven’t seen you for …’ Chris scratches his head. ‘Two years?’

  ‘Maybe more.’ Nigel nods. ‘I’m only doing NHS one day a week now. I simply can’t afford to work for you lot much more than that!’

  ‘Really?’

  ‘Yeah. I’ve moved across, jumped ship.’ He then adds in a whisper, like he’s announcing a terribly grubby secret, ‘I’ve become a proper shrink. Got a lovely little practice off Wimpole Street where I happily chat to bored housewives about their appalling sex lives. I nod and smile and listen while they tell me about their husbands climbing over them once a week, when what they really prefer is one off the Rampant Rabbit or a whole afternoon sitting on the washing machine. The real problem is, or so they tell me, once you’ve had rabbit it’s hard to go back.’ He laughs. ‘It’s very good to see you. How’s Alice?’

  ‘Good, good,’ says Chris.

  ‘The children?’

  ‘Good. Caroline is off to Cambridge soon.’

  ‘Really? Medicine?’

  ‘Sadly no. English.’

  ‘Excellent, excellent, she always was clever. Nice girl.’ Nigel rubs his hands together, looking round the place, taking in the two SO19 still pacing about. He nods towards the coppers. ‘Had a spot of bother earlier, I presume?’

  ‘Just a little shoot-out,’ smiles Chris.

  ‘Oh, the joys of the front line!’ says Nigel. ‘So, right, where’s your DSH?’

  ‘Well, good afternoon, Mr Andrews,’ I pipe up. ‘Shall we go in there’ – I point towards Andrea’s office – ‘and I can talk you through the notes?’

  ‘Good idea,’ he says, following me into the office.

  David is sitting at Andrea’s desk. He looks up and smiles at us. ‘Hello. David Smithson, Plastics. Do you need this desk?’

  ‘No, no,’ replies Nigel, ‘you carry on.’

  I sit Nigel down and tell him as much as I know about Katie and her scars and her attempt to kill herself. He listens very intently while picking bits of fluff off his blue trousers. His legs are crossed, right over left, and the right one swings repeatedly. Just as I’m winding up my diagnosis he opens his jacket and pulls out a bottle of pills. He takes two out of the bottle and with a well-practised flick of the head he knocks them straight back without the need for water.

  ‘Bennies,’ he says, catching me staring at him. ‘It has been a very long day. Is there any coffee around here?’

  Two Benzedrine and a cup of coffee is enough to keep even the most sleep-deprived rock star awake for another couple of hours. With Nigel, the effect appears to be to make him very chatty indeed. By the time Margaret has returned with a coffee with milk and two sugars, Nigel is on a roll. By the time he’s finished his cup and is ready to see the patient, it’s actually quite hard to get him out of the office.

  ‘I mean the thing is – and you, I’m sure, know this very well, David – most plastic surgery operations could be avoided if they had a bit of therapy first. Take my mate, for example. He’s an ENT guy and he had this woman in the other day who had totally unrealistic expectations about the nose job he was about to do. She arrived with her hair grown over her nose, like this big fringe.’ He gets out of his chair and starts to imitate the woman. ‘And talking to her, he found out that she doesn’t go out, because of her nose. She said kids in the street laughed at her, because of her nose, and her whole life was miserable, because of her nose. He then drew back the hair and the nose was totally bloody normal. What she needs is a shrink, not bloody rhinoplasty! She honestly thinks that changing her nose will help her lose four stone, get laid and get a job when in fact all that will happen is that she’ll have a new nose!’

  ‘There are some operations that are very effective, actually,’ replies David, trying to stick up for his specialism. ‘Breast reduction is very good for relieving back pain, for example.’

  ‘Yes, well, maybe,’ concedes Nigel. ‘But you know that is very specific. In order to get that on the NHS you have to have a BMI of less than twenty-eight per cent and you have to be removing more than five hundred grams off each breast, which is quite a substantial amount of flesh. So you have to be thin with large breasts, which is, let’s face it, quite a rare group of women.’

  ‘There’s no point in taking big boobs off a fat woman,’ says David. ‘She’ll only see her stomach.’

  ‘True! True!’ laughs Nigel, and then gives a little shiver. ‘I bet you see bosoms all the time.’

  ‘How did you know?’ says David, looking a little shocked.

  ‘You’re good-looking and a plastic surgeon. Women must ask you about their breasts all the time.’

  ‘You’re right. It drives me mad.’

  ‘Poor you!’ I say, rolling my eyes, my heart oh so genuinely bleeding for him. It must be awful to be chased by women who want to bare their breasts to you.

  ‘No, seriously,’ says David, his brow furrowing earnestly. ‘They’re always pulling their tops up and asking what I think of their breasts, and what I want to say is “I think you should put them away.” I think they think they are being amusing.’

  ‘Or trying to shock,’ says Nigel. ‘Get some attention. You should tell them to put them away.’

  ‘No, I should,’ he agrees. ‘But breast reduction does work, and I suppose to a certain extent so does gender realignment.’

  ‘You say that,’ says Nigel. ‘But they still have totally unrealistic expectations. I have a mate down the road who works at the best place on the NHS for the whole gender thing.’

  David nod
s in agreement.

  ‘They get the truckers in who want the whole shebang. Noses, vocal cord tightening, the works. Did you know that they have the highest suicide rate? Men wanting gender realignment? Something like seventy per cent if they don’t get the op before thirty-five years old. Anyway, my mate, the nose guy, had this hulking great bloke in the other day. He comes in with the dress on, and some photos, with these huge plates of meat for hands, and my mate says, “So, what sort of nose are you looking for?” And the bloke says, “My mates say that I look like Keira Knightley, apparently I have her eyes, so can I have her nose please?” Now he, I think, definitely needs a bit more counselling.’

  ‘Yeah, I would agree with that,’ says David. ‘We were always taught never to operate on a SIMON.’

  ‘A SIMON?’ I ask.

  ‘A single immature male obsessive neurotic,’ they both reply.

  ‘The outcome is always poor,’ David explains. ‘They will never be happy regardless of what you do. You are supposed to write down what you have discussed and then you are supposed to get them to sign that they have agreed with what you have discussed so that when they come back six weeks later, kicking up a fuss, you can show them what they agreed to. But, quite frankly, they should be avoided at all costs.’