‘Jesus Christ!’ says Ben, bursting through the doors of the common room like a man on at least four lines of coke, which I suspect he is by now. ‘That was heavy, wasn’t it?’
‘One of the more random things I have come across,’ I agree.
‘You OK?’ he asks. ‘I saw the puke.’
‘I’m not normally a puker,’ I say, looking down at my shoes. I must do something about them.
‘I’m sure,’ he nods. ‘But that brain …’
‘What brain?’ asks Sally. ‘You didn’t say anything about a brain.’
Ben tells Sally the whole machete story, and I have to say even she gags at the end, which makes me feel a little bit better about myself.
‘That’s amazing,’ she says, finally. ‘Are the police here?’
‘Of course the police are here,’ he replies. ‘Two men cut to pieces and no one takes any interest? Although one copper is a little worse for wear.’
I leave Ben and Sally chatting each other up in the common room and slope off to deal with the vomit on my shoes. I sponge away and rinse them under the tap in the lavs, then use the hand blower to dry them off. They are a shitty old pair of trainers, but I’ve used them more or less every day since I started here and they have coped quite well with all the piss, blood and puke thrown at them. Although having said that, looking at them now, I think I might get rid of them after this shift – a new job definitely requires a new pair of shoes, and these two are quite frankly a health hazard.
I walk back to the changing room and decide it is probably a good idea to send Emma a text message. I am going to kip down here for what’s left of tonight, I think; I can crash for a few hours then crawl back home later. I don’t think our relationship is much longer for this world, but if I text her and tell her I’m staying here that’s one less thing to beat me over the head with.
I put my hand in my jeans pocket, and just as I pick up my phone it beeps. I’ve got an email message, something from Facebook. As I click on and open it, my jaw slowly slackens. It’s from the girl who has just been here, Shannon. She walked out of here having had a miscarriage, and twenty minutes later she’s asking me to be her Facebook friend. She has even written a message: ‘Thanks for earlier, Doc. Mayb U and I cld have a drink sometime? It was nice to meet you.’ Quite apart from the fact that doctors are not supposed to shag the patients, I am gobsmacked that she thinks it’s even a possibility. I didn’t meet her, I gave her a pelvic examination. We weren’t introduced at a party. I didn’t chat her up in a club. Or even buy her a drink in a pub. I put my hand up her fanny to make sure she wasn’t going to haemorrhage. That is not the sort of thing you want to tell the grandchildren. I delete the message and turn off my phone. The girl needs help.
Back in the common room, Ben and Sally are still chatting. Actually, judging by Sally’s body language – legs crossed towards him, throwing her short nose back a lot as she laughs – Ben may well be in there. Well, it is end of term; they aren’t going to see each other again. Not unless Sally develops a sudden need for a frozen forehead or fat puffy lips. I wouldn’t be surprised if they found themselves a quiet consultation room before the hour is out.
Walking back towards A&E, I bump into Alex on his way to the toilets.
‘Is it busy in there?’ I ask.
‘My Lithuanian is going into theatre in a few minutes,’ he says. ‘Sanjay is still trying to get someone up from the morgue to get rid of yours, as he’s slightly freaking the drunks out.’
‘OK.’
‘But it’s a bit quieter now, just three alcoholics, your corpse, my machete victim and an SHO battling to remove a six-month-old rotten tampon.’
‘Oh.’ I grimace. ‘I’ve been there.’
‘Haven’t we all,’ says Alex. ‘Anyway, I’ve got to go and scrub in.’
‘So, all right do you think for me to slope off for a sleep?’
‘How long have you been on for?’ he asks.
‘Twenty hours or so.’
‘Like the good old days,’ he says. ‘You should go and ask Sanjay, but I’m pretty sure you’re fine. There are enough juniors in the place. Even if I do take one to assist me. That bloke with the VTMK gone yet?’
‘Voice to melt knickers? Who, Ben?’
‘That’s the one.’
‘He’s in the common room chatting up Sally.’
‘Sally the anaesthetist?’
‘Yup.’
‘That’s not hard, everyone’s had her,’ he grins.
‘Really? She doesn’t look like she goes at all.’
‘Like a barn door in the wind, apparently. Always the quiet ones.’ And with that he walks off up the corridor.
Sanjay is on hold to the morgue, waiting for someone to come and collect the brainless corpse. I imagine the police will be wanting to have a good look at him and then he’ll be sent off for autopsy, although cause of death is pretty damn obvious. The fainting copper seems to be back on his feet: he’s asking two of the paramedics who brought the men in questions. One of his colleagues is sitting with the lacerated survivor, hoping, I imagine, to grab any snippet that might fall from his extremely drugged-up lips.
I am just about to tell Sanjay that I’m leaving for a kip when Kareem comes running in from reception. ‘Jesus,’ he says, looking from me to Sanjay and back again, ‘can you come? I have never seen anything like it before.’
Sanjay drops the phone and I follow him into reception. Standing in the middle of the room, flanked by two terrified-looking mates, is a bloke with a face blown up like a balloon. As I get closer I can hear that the young man is wheezing like Darth Vader, gasping for air; his eyes are scarlet and he is shaking with shock. He suddenly falls to the ground, his legs buckling beneath him.
‘Ryan! Ryan!’ shouts one of his mates, crying and snotting and panicking and smacking his mate’s hugely bloated face. ‘Ryan!’
The other bloke just stands still and stares at the floor, rigid with fear. Someone in the waiting room screams. Another laughs nervously. But mostly everyone just stares in horror at the sight of Ryan coughing and gagging on the floor through his inflated head.
‘He just went to be sick,’ says the crying friend, his huge imploring eyes weeping at me, two columns of snot pouring down over the top of his mouth. ‘He vomited and screamed and then this happened. We’d only been snorting Ritalin.’
‘Quite a lot of Ritalin,’ adds his mate.
‘How many?’ I ask.
‘Grams and grams,’ he replies.
‘Your friend has vomited so hard that he has burst his oesophagus,’ explains Sanjay, crouching down to inspect Ryan’s neck. ‘And his face is full of gas.’
‘His oesophagus?’ asks the crying boy.
‘His throat,’ says Sanjay. ‘And we need to operate right away otherwise he will die.’
A ruptured, or burst, oesophagus is one of the charming complications more usually associated with alcoholics, or binge drinking. Either the oesophagus is weakened by persistent vomiting in the case of an alcoholic, and then ruptures, or the vomiting incident is so violent and traumatic (in the case of binge drinking) that the throat is torn open in one swift movement. It is obviously serious, extremely painful and life-threatening. Over 40 per cent of burst oesophaguses are alcohol-related, and 75 per cent of oesophagus cancer cases are also due to alcohol.
I have seen a few ruptured oesophaguses before, but this is the first time it has been due to Ritalin, and this also happens to be one of the more violent ruptures I have seen. Ryan is not long for this world unless Sanjay and I act fast.
He is taken swiftly into A&E and pumped with morphine and antibiotics to prevent any infection from developing in the ripped tissue. He is then given a whole load of IV fluids to replace everything he’s vomited. I offer to scrub in with Sanjay, but he insists that after twenty hours at the coalface I have given enough tonight and there is a very keen junior called Damon who is desperate to get some throat surgery under his belt as he has his eye on an
ENT consultancy prize further down the line.
So I sit around for another ten minutes or so waiting, just to make sure that our Lithuanian is taken down to the morgue. I’m not sure if he has any family over here, but he has to be formally identified and bagged and tagged and reunited with his brain before the coroner can even begin to review his case.
The morgue is usually one of the more difficult departments of the hospital to find. Since we are in the business of saving lives, we perhaps don’t like to announce our failures too much and therefore we don’t usually stretch to particularly ostentatious signage. Run by the mortuary technicians who get between £15,000 and £18,000 a year, the morgue is a place of rest where relatives can go and say goodbye but it is also kept pristine so that if we need to, we can take samples from the corpses for pathological analysis. Or at least that’s the idea.
There have been lots of scandals and incidents in the past where bodies were not properly stored in morgues, for example being kept on the floor. In one bizarre incident a Muslim woman’s body was covered in slices of bacon as a mark of disrespect. On other occasions corpses have had their pituitary glands harvested and sold on to make children’s growth hormone. Even more extraordinarily, one mortician was caught having sex with a dead body – needless to say he was fired. But our lot always seem very straight and banal, or at least that’s how they appear.
Eric has worked down in the morgue for years. At least I think that’s his name. He is not the chattiest of souls and he doesn’t wear a name badge. Conversation between us rarely moves beyond the words ‘This the one?’ and ‘Paperwork?’
He arrives smelling strongly of disinfectant and cigarettes, grunts a few incomprehensibles at me and checks the corpse is dead. There are a few stories around about corpses coming back to life in the morgue, of technicians noticing them breathing just as they are about to put them on ice, so it’s in their interest, as well as mine, to make sure the patient is definitely dead and most certainly no longer for this world.
He covers the Lithuanian with a sheet. ‘Right then,’ he sniffs, ‘I’ll be off.’
I point to the stretcher. ‘Er, I think you may have left something behind,’ I say.
‘Oh,’ he says as he nonchalantly clocks the brain and peels it off the stretcher and pops it under the sheet. Another wave of nausea hits me.
‘You lot seem to have lost your touch,’ he says suddenly as he sets the wheels in motion. ‘We are having a busy night.’
4–5 a.m.
Dear God I am tired. It’s only after you switch off and the adrenalin subsides that you realize quite how knackered you are. In the old days I would have been able to manage a double shift, no problem, and I would probably have taken Ian up on his offer of a nightcap, and stayed up until dawn remaining completely compos mentis, despite the brandies. But tonight I’m dragging my sorry arse into a bed.
As I leave A&E, Sandra is talking to Ritalin Ryan’s friends, trying to calm them down and explain that their mate will be OK, despite busting his neck open. Their OCD-like itching and scratching and shifting about, as well as their highly emotive states, makes me think they are probably all high as well. Jason ‘Meow Meow’ Grove is fast asleep in his cubicle, waiting to be taken upstairs. The drunks on drips are also getting some shut-eye, they will probably have about an hour’s grace before we start trying to get rid of them.
It’s been a heavy old day. The hangover, the double shift, my drunk girlfriend, the endless presentations, combined with the bizarre emotional upheaval of leaving this place – it’s no wonder I feel so tired.
I walk past Stacy as I shuffle up the corridor.
‘Night,’ she says.
‘I’m off for a snooze,’ I explain. ‘I’m not sure how long for.’
‘Night,’ she says again. ‘E15 is free if you want it.’
‘Great, thanks.’
I make my way a little further along the corridor. The door to E12 is slightly ajar. It looks cosy and inviting and, more importantly, closer than E15. I push the door and turn on the light. I hear the scream before my eyes manage to focus properly. And when they do, I kind of wish they hadn’t. Sally is bent over a transparent plastic emergency cot, her face pushed against the wall, her knickers and scrubs around her ankles. Ben has his underwear and scrubs around his knees and his buttocks are rippling and wobbling with enthusiasm as he takes Sally from behind. They stop for a second as they take in the fact that they have been busted. Sally looks at me, her eyes glazed, her cheeks flushed with lust.
‘Carry on, Ben!’ she barks, turning her head away from me and smacking a flat palm against the wall. ‘I’m nearly there!’
Ben does what he is told, and I am the one left to mumble my excuses and leave.
It’s normally a little smarter to lock the door, I think, as I head up the corridor. I’m not that shocked. When I was a student doctor you almost always slept with the person you were on call with. It was something to do, to pass the time, to numb the terrible boredom of it all. I think the uniforms helped a little: the old uniforms were always a little transparent, just to add that extra frisson, and plenty of nurses wore stockings, or hold-ups, which would also jolly up one’s day. The nurses were definitely more up for it then too. But perhaps that was because I was younger and better-looking and dripping with excess testosterone; also, maybe it was down to the fact that there was little else to do in Sheffield. They used to do little tricks to get us out of our clothes. One of the old favourites was spraying our trousers with water from a syringe, and then offering to help us find something dry to slip into. And there are plenty of places to remove one’s clothes in a hospital, no end of rooms and cubicles, and most of them have a bed, despite cutbacks and shortages, and most of them have a door that locks. So it really is only a question of finding two consenting adults.
I find E15 and lie straight down on the bed. I contemplate removing my shoes but I’m too shattered to be bothered even to do that. Lying down on the hard plastic-coated trolley/bed, I feel like I’m right back in my student days, and it brings a smile to my face. I loved those days. The bed in my digs was so shitty and uncomfortable you were almost chuffed to be able to sleep in the hospital. The digs themselves were dreadful, too. I think I spent the first half of the year thinking, I must get some curtains, and the other half not giving a shit. But we were never there, so what did it matter? And when I was, I was either pissed or asleep or both. It seemed pointless to bother making the eight-foot-by-ten-foot box room your own. Why would you? I think a few of the female doctors bought some cushions for their beds, but that was about the sum total of domesticity on campus.
As I lie there thinking of Julian and the ridiculous IV contraptions he rigged up so he wouldn’t feel like shit the morning after the night before, there’s a knock at my door. It is so gentle and I am so half asleep, I think I might have imagined it.
It happens again.
‘Come in,’ I say, sitting up on the bed. ‘It’s not locked.’
The door opens and Stacy is standing there, backlit by the strip light in the hall.
I am a little stunned and sleepy. ‘Is everything OK?’ I venture, not sure if I’m reading this increasingly interesting situation correctly.
‘Um, I was wondering if you, um, would mind if I came in,’ she says.
To say that this is every student doctor’s fantasy is an understatement. It’s almost as ubiquitous as the Hippocratic oath. I don’t know of a single quack worth his stethoscope who has not fantasized about a nurse arriving in the middle of the night and helping him out in his hour of need. And thank the Lord above, here is Stacy to do just that.
‘Well, um …’ I find myself saying.
I know it’s the end of term, as it were, and I know I will never see Stacy again, but I surprise myself. I don’t think I can. Much as I would love to feel her soft warm body next to mine, much as I would love to forget the traumatic exhaustion of the last day, I don’t think I can. I have a girlfriend at home, even if
she does stink of cheap white wine and Bacardi breezers. I just don’t think I can do it.
‘Oh good,’ she says, starting to take her tunic top off at the door. ‘I just thought, what with it being your last night and everything, I might be quite—’
‘Really, Stacy,’ I hear myself saying, ‘thank you, but no thank you.’
‘Really?’ She stops in her tracks. ‘Are you sure? Just a quick—’
‘No. Really. Very kind of you to offer and everything, but I do have a girlfriend.’
‘Oh, right.’ She rolls her eyes as she pulls her top down. ‘If you’re sure.’
‘I’m sure.’
‘See you later then,’ she says as she turns and closes the door behind her.
I lie there, thinking about my day – about the people who have died, about June, about the men who were attacked by their machete-wielding mate – and then I think about what I have just turned down, about what might have been, and I feel a little daft. Stacy is lovely. Stacy is sexy. It might have been fun. I can only hope that Emma is worth it.
I finally fall asleep.
They always say that the hours between four and five a.m. are the dying hours in a hospital. The time when a patient is most likely to pop his clogs. There are many theories as to why this is so. The most scientific is that cortisol levels or adrenal levels in the body drop, making the person more likely suddenly to slip away. However, I think it’s because it’s the most popular time for the night-shift nurses to take a break. So they are either having a quick one with a consultant or dunking a biscuit into a cup of tea. Either way it’s going to take them a little longer to hear an alarm bell.
I am falling into a deep sleep when there’s a knock at my door.
‘Come in, it’s not locked.’
The door opens.
Hospital Babylon Page 23
