Hospital Babylon

by Imogen Edwards-Jones

  ‘Really?’ I’d always thought that one of the more dull specialisms, looking after fractures, broken ankles and twisted knees.

  ‘Yeah, then I could have a private practice specializing in sports injuries and operate on the Chelsea football team.’

  ‘In Harley Street?’

  ‘That’s overrated,’ he says.

  Actually, he’s right about that. Harley Street is a bit overrated these days. Although it’s getting better than it was. Its reputation has become tarnished a little over the years, mainly due to the high rents and the widespread practice of subletting. A large proportion of Harley Street properties are owned by the Howard De Walden Estate, which is extremely careful who it rents to, as are the Crown Estates that also own swathes of the area. However, this did not preclude doctors renting properties and then sub-letting them to other doctors, which led to the practice of hot-desking or hot-officing. So a doctor could say he has a Harley Street address and consultation suite when in fact he only uses it on a Thursday afternoon between three and six p.m. The powers-that-be have recently woken up to this and are trying to clamp down on it, but when the rents are £6,000 a month for two small treatment rooms, you can kind of see why it happens. For the same amount of money you can have ten rooms on Wimpole Street. But it just doesn’t have the same cachet. Weirdly, where you are on Harley Street dictates how much your rent is. The lower the number, the more it costs. Number 1 Harley Street is the most expensive address in the street, whereas 150 will be at least 30 per cent less expensive to rent.

  ‘I wouldn’t say it’s overrated,’ says Sanjay, joining in. ‘It has a worldwide reputation. I have a friend who does plastic surgery on the street and he says he can’t move anywhere else. For Arabic patients from the Middle East, Great Britain means three things: Harrods, Knightsbridge, for shopping; Edgware Road for the hubble-bubble; and Harley Street for medicine. Oh, and Regent’s Park is the countryside.’ He laughs. ‘It’s true. If you tell them to take their bloods to Wimpole Street they say it is too far. If you ask them to come to Devonshire Place, they get completely lost.’

  ‘You would have thought all those Botox places would’ve taken a kicking in the recession,’ I say.

  ‘You’re kidding, right?’ says Ben. ‘Lots of the small country clinics are going bankrupt, but all the good places like my mate’s place are packed. Their billions may have become millions, but women for whom Botox and fillers are the norm don’t feel dressed without it. It’s like going to the hairdresser’s for them. Also, famously, lipstick sales go up in a recession: you may not be able to afford the shoes and the dress but you are sure as hell going to keep your lips pillow perfect.’

  ‘I always think they look disgusting, those big fat lips, like you’ve been in a fight with your orthodontist,’ I say.

  ‘I know,’ agrees Sanjay. ‘But the big lips are very popular with the Arabic women. They’re used to wearing very heavy make-up. Like us in Delhi, they like their movie stars with big features, so they like the big lips and the big cheekbones.’

  ‘And the Russians are hilarious,’ adds Ben. ‘They are so designer-obsessed that they ask for their fillers by brand, so they insist on Sculptra instead of another derma-filler.’

  ‘And the Brits like boob-job tits,’ says Sanjay. ‘Ones that actually look fake. We can do much better tit jobs these days, but still you lot want them hard and with a runway in the middle like a WAG. They are a status symbol, not a thing of beauty!’

  Melissa comes out from behind the curtain, and I am afraid to say we all stand and stare at her breasts. Ben does so because he knows they are great, I do because I’m checking out Ben’s recommendation, and Sanjay does so because he’s talking about British boobs. We all fix our gaze and tacitly agree they are rather good.

  ‘All right?’ she says, staring at the three of us staring at her. She is a little confused.

  ‘Yes, very good,’ I say. ‘You?’

  ‘Very good. Two glasses of champagne and five chocolate-coated strawberries since breakfast,’ she says. ‘I think I can work with that.’

  ‘Oh yes, right,’ I say, suddenly realizing what she is talking about. ‘I think I’d better go and see if Mr Armstrong has arrived yet.’

  ‘Do you need to?’ she asks.

  ‘Yup,’ I say. Anything to get out of this situation.

  I arrive outside the front of the hospital to see a black Ferrari sports car pull up on the yellow zigzags. Extremely loud classical music is pouring out of the open window. The engine stops, as does the music, and a lean, neat, handsome white-haired gent nips out the opposite side of the car. I know he must be knocking sixty, or indeed over it, but he looks fit enough to beat a twenty-year-old in a triathlon. He locks the car with a swift bleep and throws an expensive-looking dinner jacket over his shoulder. He has undone the dickie bow, and he’s sporting a pair of highly polished shoes. He also has one of those leathered, weathered deep tans that only comes after many winter top-ups on a Florida golf course.

  ‘Mr Armstrong?’ I say.

  ‘It’s all right here, is it, the car,’ he states rather than asks.

  ‘Absolutely,’ I agree.

  ‘Don’t you just love Haydn?’ he asks in a manner that demands you agree. So I do, even if I can’t name a single piece of his music. ‘Excellent,’ he says, patting me on the back. ‘Very important to have some good music while you operate.’

  ‘I do hope we haven’t dragged you away from something important,’ I say.

  ‘Oh, just another one of those dinners where you eat indeterminate fowl in an indeterminate sauce and show off how many papers you’ve written. I was sitting next to the wife of the surgeon who had written the haemorrhoid chapter in some new compendium. It was riveting.’ He roars with laughter. It’s loud and raucous, the sort to make small babies cry. ‘Anyway, fill me in on our dear patient.’

  We walk and talk and I explain to Mr Armstrong exactly how far up the colon the purple vibrator has managed to work itself.

  ‘What is it with heterosexual men and their bottoms?’ he asks loudly as he walks up the stairs. ‘Last week, at another hospital that I cover, I had a company director who had a carrot up his rear, inside a French letter. I did think about asking him how it got up there but I just couldn’t be bothered to listen to a poorly worked-through story.’

  ‘I’m sure it gets rather tiresome after a while,’ I say.

  ‘No,’ he says. ‘There are certain little things that are sent by the Lord to amuse you. I took a pepper pot out of another backside a few years back, and down one side it said “Welcome to Margate”. That tickled me for weeks. I have had a small statuette of Napoleon, a Brighton pier, a Blackpool Tower a few times. And a couple of sticks of rock.’

  ‘I sense a seaside theme,’ I say.

  He rocks with laughter and slaps me on the back again.

  ‘Of course I don’t just remove foreign objects from the rectum,’ he says.

  The poor bloke is one of the leading specialists in bowel cancer and reconstructs a bowel so brilliantly that the majority of his patients don’t leave wearing a bag. He is extremely talented, and to be honest I am a little embarrassed at his being here.

  ‘I tell you one thing about my profession over the other more glamorous surgeries.’ He smiles, then lowers his voice. ‘They are always very grateful. One of the sad things is that everyone leaves their diagnosis much later than most other things due to embarrassment. They are prepared to suffer symptoms they wouldn’t accept anywhere else out of mortification. So by the time they get to me, they are often quite desperate.’

  Before he meets another grateful customer, I take him to one side to show him the X-rays. He switches on the light box opposite the computer and nearly the whole department comes to take a look. The dildo is huge and there for all to see, including the outline of the two long-life batteries. A few people giggle at the sight, most people wince, and there are a couple of sharp intakes of breath.

  ‘That is quite far up,�
�� he agrees. ‘I’m not sure that is quite the result he intended when he popped it in this afternoon.’

  ‘Do you think we should leave it in until the batteries run out?’ I ask.

  ‘Not unless we want to leave him with permanent damage,’ he replies. ‘They are quite determined, these things. Once they get going it’s hard to stop them. It’s travelled far enough already.’

  ‘Then it might get nasty,’ I say, staring at the bizarre X-ray. Why would you want to do that to yourself?

  ‘That’s not nasty,’ insists Mr Armstrong. ‘One of the worst things I’ve seen is a man who used to enjoy lowering himself on to the shaft end of a feather duster using a stepladder. Until one fine day the stepladder slipped and the broom ended up in his neck. His guts were transfixed. He had speared himself with a feather duster.’

  A hush goes over the small gathering by the X-ray light box. A few stare open-mouthed at Mr Armstrong. He continues to look at the plates, somewhat oblivious to the fallout from his story.

  ‘Did he live?’ a nurse asks finally.

  ‘Don’t be ridiculous,’ barks Mr Armstrong. ‘DOA. Let’s go and talk to our Mr Hughes, shall we?’

  10–11 p.m.

  I leave Mr Armstrong to discuss the pros and cons and possible outcomes of the bum op with Mr Hughes. He is no longer my patient, though I will of course come and check him over after he has come out of theatre. I think I might use this quick opportunity to go, via the changing room, and grab an overpriced sandwich from downstairs. The main canteen is closed now, which I always find a little annoying as this place is open twenty-four hours a day. Apparently there isn’t much call for toad in the hole and chicken curry at three a.m., but I beg to disagree. So we have to make do with the small selection of sandwiches available at the shitty kiosk on the right as you come into the hospital. There is a fridge to the left of the till that boasts month-old Ginsters pies on one shelf and a few cheese and tomato sandwiches on the shelf below. Chilled within an inch of their lives, they are usually wet and soggy by this time of day as they near the end of, or indeed pass, their shelf life. They occasionally have a wrap, with something tandoori’d inside, but I refuse to eat a wrap. It’s like chewing a dank newspaper and so goddamn depressing.

  On the ground floor, the place is empty and the lights have been turned down low. It’s almost like the hospital pretends to be closed, deterring as many ‘customers’ as it can. There are two blokes sitting at the front desk, both reading free-sheets with their feet up on the desk. A few flickering TV screens in front of them show various corridors, doorways and car parks; neither of them is paying much attention.

  ‘Evening,’ I say.

  Neither of them bothers to look up, let alone reply.

  On the far side of the entrance hall, a cleaner polishes the lino floor. He is wearing earphones, the music turned up loud against the polisher’s low hum. He looks up at me, but his face does not react in the slightest. I am invisible to him. He checks the clock on the wall above my head before turning his back and carrying on.

  In the shop, which the hospital sub-lets to claw back a tiny bit of income, the assistant is asleep. He is sitting on one of those wheelie footstools, leaning against a pile of old newspapers. The shop actually closes at ten p.m. but since he has failed to shut up properly I am hoping he might serve me.

  I grab a soft white sandwich from the fridge. I don’t even care what’s inside it. ‘Evening,’ I say. ‘Can I just have this?’

  The man rubs his eyes. ‘Three pounds,’ he says.

  ‘Three?’ It’s almost worth leaving the building and popping to the nearby twenty-four-hour garage. Such a rip-off.

  ‘Three,’ he repeats, sticking his dry, cracked hand out for good measure.

  I feel a surge of irritation. If I weren’t so hungry and pushed for time, I might just chuck the soggy thing back in his face. I put down the three coins I pulled from my jeans pocket a few minutes ago and tear open the plastic packet. It’s tuna and cucumber – at least that’s what it vaguely tastes like. I’m not entirely sure. The textures are wrong, and I’m sure that if I looked at the ingredients carefully I’d see that some sort of substitute has been used for the crucial elements. But right now I don’t care and I have finished the thing before the lift arrives to take me back up to the first floor.

  Once inside A&E I am presented with my first pisshead of the night. According to Sandra, who fills me in as I burp into the back of my hand, he was found in a car park by the police, out cold, next to what they presume is his car. He is too drunk to give his name, he can barely stand, and it took two nurses to ‘walk’ him into the cubicle. The shocking thing is, he is wearing a shirt and tie and the label inside his suit says Paul Smith. So the bloke must have a bit of money. Where are his mates? Where are his work colleagues? Why didn’t someone see he got home? How does someone let themselves get so drunk that they pass out in a car park next to their own car? And he does stink of alcohol – the sweet heady smell of too much wine. I have to say, over the years that I have been doing this job, I have grown to hate that smell. I know it’s hypocritical because I was drunk last night too. But this smell combined with the disinfectant and the strip lights … it’s just such an unpalatable combination.

  To be honest, alcohol is the bane of our lives in this place. Alcohol-related admissions have doubled since 2006, accounting for over eight hundred thousand of the cases we have to deal with, and costing the NHS more than £2.7 billion a year. Quite apart from the fact that it is completely self-inflicted, it’s the bad behaviour, the abuse, the fights, the insults, the shouting, the spitting, the vomiting and the pissing that goes with the alcohol that makes it so annoying.

  The police are also quite naughty: they bring a passed-out drunk to A&E simply because they don’t know what to do with them. The police cells are full, and they can’t be bothered to charge them for being drunk and disorderly. Short of driving them home like a very reliable cab service, they have no option but to bring them here. We are then, of course, obliged to check them over for head injuries and see if they have damaged themselves in some way before administering ‘fluids’.

  There are two schools of thought about fluids. The first is, give them as many fluids as possible in order to dilute the alcohol, sober them up and get them on their way so that we can have the bed back as we are not running an alternative B&B service. The second is, don’t give them too many fluids as they will only end up pissing themselves and then we’ll have something else to clear up. There is of course a third view: give them as many fluids as you can in order that they do actually piss themselves and therefore humiliate themselves into never, ever getting so completely drunk again. Sadly, the one flaw in this, apart from having to clear up a whole load of urine, is that some people don’t have a very sensitive bladder reflex when drunk, so instead of peeing automatically when the bladder is full they end up rupturing their bladders, which is a whole new ball game.

  This dignified end to a night, resulting in major surgery and someone stitching together your exploded nether regions, used to be an entirely male preserve and completely unheard of in women. But now they are catching up. The number of women drinking regularly currently stands at 86 per cent, which is almost the same as blokes, of whom 91 per cent are regular boozers. So it’s only a matter of time before we have as many female bladder accidents as male.

  The orderlies have wheeled Mr Hughes off for his bum op and taken both Gabriella and Andrew up into the ward to recover from their ordeals, thankfully freeing up some space; which is fortunate because my drunken suit suddenly jerks himself up off the bed and sprays half the section in vomit.

  ‘Oh Jesus Christ!’ says Stacy as she looks down at her blue tunic covered in yellow bile, diced carrots and half-digested pizza. ‘I’ve only just put this on!’

  I have to say I feel exactly the same. I’m now beginning to forget how many times I’ve changed today. Thank God he missed my shoes. I’ve never been one for putting on the bag feet
, and there’s nothing worse than squelching about in puke for the rest of your shift.

  Sandra is straight out of the office, her thin face now looking even more pinched and grim. She rustles up cleaners and mops from nowhere, while Stacy and I walk off to change.

  ‘And so it begins,’ she says to me, wrinkling her small nose.

  ‘I know,’ I sympathize. ‘And I thought tonight might be quiet.’

  ‘You hoped it might.’ She smiles. ‘This is me,’ she says, going into the ladies’ changing room.

  Five minutes later there’s a knock on the door of the blokes’ changing room and Stacy walks straight in before I have a chance to say anything.

  ‘Are you ready yet, doctor?’ she asks, smiling as she catches me in my scrubs trousers looking, yet again, through the pile for a top my size.

  ‘Um, not quite there, actually,’ I say, feeling my cheeks redden.

  She deals with and looks at naked people all the time; why am I embarrassed for her to see me without my top on?

  ‘Do you want a hand?’ she asks, coming closer. ‘What are you? A large or an’ – she licks her lips lightly – ‘extra large?’

  ‘Just a large,’ I say, trying not to catch her eye.

  The thing is, Stacy is quite sexy. She is tall and slim, with dark bobbed hair and a whiff of a Scottish accent. I just never expected her ever to come on to me. I know she’s been around the department a bit but she has never shown any interest in me before. I silently thank the Lord for the ‘Black Wednesday effect’ … and then, rather annoyingly, an image of Emma pops into my head.

  ‘Here you go,’ she says, flapping out a top and coming even closer. ‘This is your size.’

  ‘ ’Ello, ’ello, what’s going on in here?’ comes a voice.

  Another doctor, Mark, marches straight in through the door. Stacy and I leap apart.

  ‘Call me old-fashioned, but I was under the impression this was a gents’ changing area for changing gents.’