Hospital Babylon

by Imogen Edwards-Jones

‘I was just helping,’ says Stacy, giving me a wink as she walks out.

  ‘Evening, Dr Death,’ I say. ‘I didn’t know we had the pleasure of you tonight.’

  ‘Last night only,’ he grins.

  Mark is called Dr Death because, surprisingly enough, he killed someone. The person died at the end of his needle after he drew up a massive dose of potassium instead of painkiller, which stopped the patient’s heart. He was a junior at the time, a student fresh out of medical school; it wasn’t actually on Black Wednesday but he had only just started. The hospital didn’t so much cover it up as suck it up. He was never investigated. He was never suspended. They just said ‘Don’t do it again’ and he carried on. I have to say that even now, some four years later, I’m not that keen on having him on the shift with me. Some people think he’s bad luck to have around; I just think he’s not so much incompetent as a little bit crap. And he’s a bit of a dickhead, too. The sort of person who gives you the two-fingered pistol-shoot greeting across the canteen. Anyway, I tend to try and give him a wide berth.

  ‘You on tonight, then?’ I ask, pulling my scrubs top over my chest.

  ‘Yup,’ he says. ‘Ten till six, that’s me.’ He looks me up and down. ‘They really are serving up the dregs tonight.’

  I leave the murdering idiot to put his scrubs on and go back out to A&E to check on my drunk. There’s only a residual smell of vomit in the area, mixed with a more potent smell of alcohol and disinfectant – the usual evening aroma sported by the department. The bloke is passed out, snoring on the bed, with an IV of fluids in his arm. The vomiting has clearly done him some good as he looks a little less red and sweaty and on the verge of a heart attack. Although he looks a little better, he still has to sleep off his drinking binge, and as we won’t admit him to the hospital, he is going to lie there and block a cubicle because there is nowhere else to put him.

  ‘Hi there,’ says Sanjay, poking his head around the curtain. ‘If you’re not busy I’d like you to come and scrub in with my patient.’

  ‘I’m not sure I can,’ I say. ‘What’s the problem?’

  ‘A bleed behind a breast augmentation. I’ve got to take the bag out, stop the bleed and check to see if the bags themselves are punctured. She says they are saline bags but it’s been done on the cheap, so we need to make sure she’s not leaking silicone into her system.’

  ‘OK,’ I say. ‘Where did she have it done?’

  He names a clinic I’ve never heard of, but then there’s no change there. Half these clinics come and go all the time; they run out of money and close, they get a poor rep and close. Some 66 per cent of them are not properly equipped and only 22 per cent of them have a resus team on all the time. We are endlessly clearing up after botched bloody plastic jobs.

  They are almost as bad as the Independent Sector Treatment Centres, which are the bugbear of Chris Williams. Set up over five years ago, these private clinics, paid for by the NHS, are where so-called bulk operations are performed. The doctors who work there are not vetted in the way we are and are supposedly much less experienced. They also don’t have the same aftercare system we do. Chris is always complaining about having to sort things out after some doctor has flown over on Ryanair, rattled off some botch job and pissed off again. He says the worst thing about many of these doctors is that they don’t actually kill their patients, they maim them, leaving us with hours of corrective surgery to clean up their mess. We’ve had cases of hysterectomies without consent; of knee and hip ops done so badly we’ve had to replace the whole joint. One terrible statistic states that if you have a hip op at an ISTC you are twenty times more likely to have to have it repaired on the NHS.

  Not that we are beyond reproach ourselves of course. We have quacks like Dr Death still walking, talking and working among us. Only six months ago we had a bit of a problem with the operating theatres. Patients kept on getting post-operative infections so the whole place was cleaned and disinfected and sterilized over and over again, and still it kept on happening. Eventually they managed to get the resident microbiologist to grow some of the bacteria, and to everyone’s amazement it was faecal. After much toing and froing and asking around, the outbreak was whittled down to one surgical registrar who had terrible piles and was itching his arse during operations.

  Sanjay disappears off to find someone else to assist him when Melissa comes up to inform me that Mr Hughes has come through OK and is coming round in the recovery room at the end of the corridor. When I walk in I am met with the usual sight of about six gently moaning bodies lying flat out on trolleys. I am always struck by how much this place, devoid of the mumbling and the beeping machines, reminds me of the morgue. I think it’s the thin yellow curtains that hang between each body, or the fact that they’re all laid out. Either way, it always freaks me out a bit.

  Mr Hughes is lying next to an intubated woman with an oxygen mask over her face; she is motionless and looks extremely uncomfortable. Mr Hughes is turned on his side. I imagine he’ll be sleeping in this position for some time to come. I don’t think the operation was particularly complicated, but it must have been rather painful. Mr Hughes will be kept in, certainly overnight and possibly for another twenty-four hours after that. He certainly won’t be allowed to leave until he has passed a normal stool. I look over his charts. His stats are all fine; he seems to be well.

  ‘How are you, Mr Hughes?’ I ask.

  ‘Fine,’ he says, sounding very sorry for himself.

  ‘A little uncomfortable?’ I ask.

  ‘Mmm.’

  ‘Good, well then, you’ll be going on a ward soon,’ I say. ‘We’ll keep you down here for half an hour or so just to make sure everything’s OK, then we’ll move you.’

  ‘Mmm,’ he says again.

  ‘OK,’ I say. ‘Is there anything else?’

  ‘Yes,’ he says, suddenly and rather sharply. ‘Can you get rid of the thing on the end of my bed?’

  I look at the foot of his bed and in a glass jar, the sort of thing we use to store gallstones or tumours that patients want to keep, is the vibrator. Mr Armstrong is either being a little bit wicked, or he genuinely thinks that Mr Hughes might want to take the big purple cock home with him as a souvenir. My money’s on wicked.

  ‘If you’re sure?’ I ask, picking up the vibrator-in-a-jar.

  ‘Completely,’ he says, curling himself up into a tight ball.

  I walk back down the corridor holding the glass jar. I’m not quite sure what to do with it. I suppose technically it’s surgical waste and should be incinerated, along with the sharps, swabs and other unpleasant detritus.

  ‘Oh, what’s that?’ asks Ben as he bumps into me.

  I hold it up for closer inspection.

  ‘Is that going into the girls’ changing room? You should put a sticker on it: “In case of emergency, break glass”.’ He laughs. ‘I’m sure they’d find it useful.’

  ‘I think technically I should throw it away.’

  We both inspect it a little more closely.

  ‘It’s not that clean,’ I add, recoiling slightly.

  ‘No,’ he agrees, his nose curling. ‘Definitely one for the bin.’

  I am just disposing of the vibrator in a yellow clinical waste bucket in the cubicle next to my drunk when Mark sticks a rather sweaty-looking face around the curtain.

  ‘Fuck, man! You’ve got to help me,’ he says, staring down at his bloody rubber-clad hands. ‘I’ve got some Saudi monoglot next door who’s got a nose that just won’t bloody stop bleeding.’

  I obviously look at him with a puzzled expression.

  ‘Help me! He’s dying!’

  I follow him through the curtain to find an elderly Arabic gentleman lying on the bed dressed in flowing white robes, with blood pouring out of his nose. It is rare to die of a nosebleed. You have to lose a lot of blood out of a relatively small exit. It’s not like being stabbed. There really has to be a substantial flow. But this man looks well on the way. His face is drained of colour and he l
ooks weak and feeble, not long for this world.

  ‘How long has he been like this?’ I hiss.

  ‘I don’t fucking know,’ says Mark, wringing his hands slightly. The man is panicking. ‘I don’t know how to stop it either. I mean, every single bit of cotton I’ve stuffed up there is just soaking it up. We’ve run out. Connie’s gone to get more.’

  ‘Here you are!’ says Connie, arriving all red-faced and equally panicked.

  ‘I mean, he’s going to be dead in ten minutes if someone doesn’t fucking do something fast,’ announces Mark. His thinning blond hair is stuck to his head. ‘Is Ian still here? He’d know what to do.’

  ‘I can actually speak English you know,’ comes a voice.

  Mark, Connie and I all stare at the patient.

  ‘Oh,’ says Mark.

  ‘Oh,’ I repeat. ‘I was told that you didn’t.’

  ‘He presumed,’ continues the patient. ‘I am an English teacher, actually. And this has happened to me many times before. What you need to do is this …’

  I leave a completely mortified Mark to take instructions from his patient on how to stem the rampant blood flow and go next door to check on my drunk. I peel back the curtains and take a peek. I sigh. The man is fast asleep, his mouth is wide open, he’s snoring like a trucker, and he has wet his trousers.

  11 p.m.–12 a.m.

  Stacy and I debate whether to leave my drunk, Richard, in his clothes. Stacy has been through his jacket pockets and worked out that he doesn’t live that far from the hospital.

  ‘I think I might go through his phone and call someone to come and get him,’ she says, holding his mobile. ‘I mean, he really is cluttering up the place, vomiting and urinating everywhere.’

  ‘Have a go,’ I agree. ‘And as soon as he can sit up, get rid of him to the CDU.’

  I’m not sure how many patients are sitting in the clinical decision unit at the moment, but I’m sure Ian, Alex and Sanjay will have offloaded a few by now. I walk through the A&E waiting room to check.

  The CDU is even more grubby than the A&E waiting room, mainly because it’s completely devoid of frills. There is no TV, no table full of jaded, dog-eared magazines and crumpled free-sheets, no water-cooler, in fact nothing but six rows of red plastic chairs and a slowly atrophying spider plant. Asleep in one corner is a drunk who I think Ian bagged, tagged and dispatched almost as soon as the man could sit up without slumping sideways. There’s a man with a bandaged arm who also looks like he’s sleeping off the effects of a liquid lunch, tea and dinner. There’s also a granny who is pacing around, undoubtedly crazy with a kidney infection. The corridors of this hospital are always full of old ladies who have made themselves ill by forgetting to drink enough water. They wander around, waiting to be seen, waiting for someone to take any notice, or even sometimes, if they are lucky, waiting for the antibiotics to kick in. This granny is rather frail and extremely little. She must be all of five foot and she looks like she’s knocking on the door of eighty.

  ‘All right, dear?’ I ask, bending down to her height.

  ‘Is that you?’ She stares at me. ‘Graham? Is that you?’

  ‘Hello there,’ I say. ‘I am not Graham. Has anyone seen you in the hospital?’ I gently take her hand and look her over. She has a couple of plasters on her arms, which means she must have had some IV antibiotics. ‘Who treated you?’

  She looks blank.

  ‘The name of your doctor?’

  She looks like she’s trying to think. Her lined grey forehead frowns. ‘Graham,’ she suggests.

  ‘I think I’ll go and take a look,’ I say. ‘You stay there.’

  ‘Here,’ she says.

  Poor woman, I think as I walk back towards the department, she really doesn’t know if it’s Tuesday night or breakfast time. She’s so elderly and vulnerable I’m not sure she should really be left anywhere on her own, least of all a grotty CDU with little or no supervision.

  The waiting room is looking surprisingly unpacked, I think as I come through the doors. It’s increasingly airless and the smell of fast food is slowly being trounced by beer, cheap wine and whisky.

  ‘Hello there, handsome!’ comes a familiar voice.

  I turn round to see Emma standing in the doorway with her mate Jilly.

  ‘Hi there!’ Jilly waves.

  ‘Muhammad couldn’t get out to play with the mountain, so the mountain has come to see you!’ declares Emma as she weaves her way towards me and kisses me on the cheek.

  The kiss is wet, and she stinks of booze. I feel my stomach tighten slightly; my mouth goes dry as it dawns on me: she smells like a patient. There is something about her being here, slightly drunk, under the cold light of the neon strips, that makes me feel nauseous. I’m not annoyed that she’s here. If she were sober, I’d be pleased to see her. But the smell and the state of her make me want to dump her right here and now. It’s irrational, I know, but I can’t help it.

  She runs her hands over my cheeks and squeezes one of them, like I’m two years old. It makes my skin crawl.

  ‘Don’t you look all sweet in your jumpsuit,’ she giggles.

  ‘He looks sexy,’ Jilly joins in. ‘Just like George Clooney!’

  ‘Help me, doctor!’ says Emma, clutching her right breast. ‘I think I might have a heart problem!’

  ‘It’s the other side,’ I say.

  ‘Of course it is!’ She bursts out laughing.

  ‘God, you’d make a shit nurse!’ yelps Jilly.

  Half the waiting room have stopped whatever fascinating thing they were doing and are watching the show.

  ‘But I’d look great in a uniform,’ Emma says, pouting and pulling her shirt low at the front and squashing her breasts together. She messes up her hair, licks her lips and tries to look sexy. She just ends up looking more drunk.

  I have to say I am now beginning to fight feelings of deep revulsion. There is nothing I’d like more in the world right now than for her and her pissed-up pal to fuck off.

  Working here really affects your personal life in ways you could not possibly imagine. Quite apart from the long hours, the high stress, and the matter-of-fact attitude you have to things like cannulating yourself and popping extremely strong cocktails of drugs to make you sleep, keep awake or just plain feel a little bit better, we also become inured to a lot of things. After you have seen life and death at its most raw, visceral and gruesome, you become cauterized, so much so that it is often quite hard to get emotional about anything. Bizarrely, we are part of society, at its front line most of the time, yet we are also isolated from the rest of the world. The intensity of our shift means that something could happen on the outside and we would not know anything about it until some six or eight hours later. Some mates of mine only found out about 9/11 four hours after the event, and that was only because A&E was suddenly empty: everyone had gone home to watch the telly.

  All this impacts in obvious ways on our personal lives, but sometimes in ways you might never think of. Plenty of surgeons I know, in fact most of them, have a dislike of the naked human body. We don’t find it sexy or alluring. I think it’s because we associate it with work, or possibly problems. All I know is this: if you want to turn on a surgeon, flash some flesh, show a shoulder or some ankle, but keep your clothes on. Most of us like a woman in underwear. I think we have spent so long trying to desexualize the bodies we operate on that a prostrate naked form is no longer attractive. And woe betide anyone who is going out with or is married to a gynaecologist. Imagine what looking at fannies all day does to you. And as Sanjay pointed out a few weeks ago when we were discussing this very thing, they are not necessarily fannies in good condition either, they have cysts, abscesses, fibroids or some such hideous complication. Eventually it does start to get in the way of your sex life.

  Anyway, my pet hate, when I have not been drinking myself, is the stench of alcohol. If I had been out and about with Emma my reaction to her flirting and pouting in front of me would have been different. But I
have been working now for sixteen hours. I’ve seen two people die, and witnessed a resurrection. I have been covered in blood three times and puked on once. So you can imagine how jolly and well developed my sense of humour is right now. Quite apart from the fact that the patients are beginning to stare. I need to command respect from these people. I need them to think I’m infallible, that not only is my opinion valid, it should not be questioned.

  ‘What do you think, doctor? Shall I take your blood pressure?’

  Emma is smirking at me. Her eyeliner is smudged down her cheeks; her lipstick is bleeding into the tiny lines around her mouth. And she smells like a pub.

  ‘How much have you had to drink?’ I ask, fighting the waves of irritation that are coming thick and fast.

  ‘Just a couple,’ she says, wobbling slightly on her feet.

  ‘Of bottles!’ shrieks Jilly, falling backwards into a bin. ‘Oops!’ She laughs. ‘I didn’t see that there!’

  ‘Can you just go,’ I say, as quietly and firmly as I can.

  ‘Go?’ asks Emma. ‘But we’ve just got here. We wanted you to show us around. Maybe have a look in the operating theatre.’

  ‘Steal some drugs!’ hoots Jilly, getting out of the bin.

  They now have the attention of everyone in the waiting room – everyone who’s still awake, that is.

  ‘Can you please leave,’ I say again, putting my hands on their shoulders, trying gently to usher them towards the double doors.

  ‘There’s no need to push me,’ declares Emma, beginning to get annoyed that her late-night visit has not been received with open arms.

  ‘I’m not.’

  ‘You are!’

  My heart sinks. Now she’s going to get pissed off. Drunk and pissed off.

  ‘Everyone’s looking,’ I say, still trying to corral them towards the door.

  ‘Well let them!’ laughs Jilly. ‘What are you lot staring at?’

  ‘Come on, please,’ I say. I am prepared to beg.

  ‘Get your hands off me,’ says Emma. Her voice is raised. She is going to start shouting any minute.