Once Rosie had fluttered out – she was of that dainty butterfly mold, with a head of thick, bushy hair – Birgitta sat herself down at the computer and skimmed through which pills or drips were to be administered at 10 pm. The more detailed reading she’d save until later. Looking over her shoulder, Anne-Sofie checked who she was to take the temperatures of so she could get that over and done with.
They then did their medication round at their easy pace, working as usual in perfect harmony.
They’d completed a few rooms when the on call doctor called asking to admit a patient. Birgitta went out into the corridor to take the call so that no one in the room would overhear anything by mistake. Rashly spoken words were easily caught and given wings that flew far beyond the hospital walls.
Acute abdominal pain, said the doctor. She heard by his voice who it was. Christoffer Daun. Annelie had married up, having netted a doctor. But her husband was not the sharpest scalpel in the box, none of them would claim that. He was popular with the patients, though. Especially the female ones. He was a good listener, they said. He definitely had a personal need to be liked or at least admired, but as long as everyone was happy and no one reported him for making improper advances, there was nothing for it but to let it pass. And she guessed that he knew exactly how far he could go. He was an intuitive plucker of the female heartstrings.
Calling now, he said that he didn’t think it was the appendix; so the patient was just in for observation, in other words. The tests hadn’t all come back but, hey, he couldn’t send her home, could he? he said, with a diffidence that Birgitta immediately detected.
“Given that her dog’s just been run over…”
“Her dog?”
“Right. That’s kind of why she needs a bed. You’ll see what I mean when you see her.”
He was of a compassionate cut, and that was good. But sometimes it was perhaps more about passing the problem onto someone else, about their not having time down in A&E, and about there being precious few other places that were open 24/7 for people in need.
Birgitta breathed as silently as she could down the phone so that he wouldn’t think she was sighing.
“And if anyone can handle her, you can!” he said with emphasis. He knew that flattery would get him somewhere.
Birgitta wasn’t one to protest openly. She hung up and continued with Sofa to a woman who’d undergone gall bladder surgery and was due to be discharged the next day. She’d pressed the alarm because she was in pain again, and she showed them with her hand where – high up, although on the left side where her gall bladder had not been. Apart from the operation she was in full health and only fifty-three years old. She looked a little ashen, possibly in a cold sweat. They talked a while.
“Look, I think we’ll run an ECG on you. Just to be on the safe side, really,” said Birgitta. “I’ll call the doctor later and ask him to take a look at you.”
Her tone was calm, as she saw no reason to cause the patient unnecessary worry. She asked Sofa to take her temperature – 100.2 – and then took a fresh blood count.
“Just a little prick on your finger,” she told the patient, thinking to herself that the problem might be a hemorrhage. Or a nascent infection. Unless it was her heart, which seemed a bit far-fetched given how bright and alert the patient had appeared earlier.
“Pah, it’s probably not that bad,” said the woman in the bed. “I feel a lot better just having had a chat with you.”
Sofa went away to fetch the ECG machine and came rolling it along in the corridor just as they heard the door at the end open. By then, Birgitta had noted that the woman’s blood count had dropped slightly, but not alarmingly so. She’d take it up with the on call doctor later. The AAP with the dead dog appeared, supported by one of the A&E nurses. Doubled up and moaning, her face twisted, she came hobbling along. At least she wasn’t on a stretcher.
Birgitta walked up to her, and Anne-Sofie let go of the ECG to join them. The girl was twenty-something and wailed in Birgitta’s face as she removed her coat – which was heavy, as if she’d filled her pockets with rocks or everything but the kitchen sink – and led her to a bed. It was clear from her hold on the patient’s upper arm that she was emaciated. Greasy, streaked hair hid her face and her clothes fit poorly. Her body language gave off two simultaneous messages: Don’t touch me! Take care of me!
“I don’t wanna live any more,” sniffed the young girl loudly.
“There, there, come with me,” said Birgitta, and placed a finger over her lips to indicate that she should tone it down, other patients were trying to sleep.
“Fucking hell, how can I be quiet when my belly’s killing me? You can’t make me! Jesus H Chriiiist! I wish I was deeeead!” She screamed until her face turned red, doubled up again, and collapsed into a kind of squat.
Oh my God, thought Birgitta. She shouldn’t be lying here wasting away, she should be in psychiatric care in Västervik.
She exchanged a knowing glance with Sofa. Both were trained in keeping their heads and not getting worked up.
It was the pain in her stomach. The doctor wanted them to keep the patient under observation over night, anyway, and then they’d see what was to be done with her. It could, after all, be her appendix. Appendixes could be deceptive.
They helped the young woman out of her clothes, which reeked of cigarette smoke and needed a good run through a washing machine. They chatted with her and she eventually began to calm down. She was indeed thin, and her nails woefully bitten down to the quicks. I wonder if she’s a junkie, thought Birgitta as she scanned the girl’s arms for needle punctures. There was already a large bandage covering the crook of one her arms from the blood test she’d been given in A&E, and her forearms were covered in discreet scratches and bruises. It looked like she had a tough life. Birgitta assumed that they’d screened her for blood infections down at A&E, and she’d soon be getting the results.
The patient’s name was Nilla Söder.
“You’ve gotta give me something for my stomach,” she whined, then folded up like a penknife in the bed. “I need a shot of something!”
“The doctor wants us to wait a little before giving you any powerful painkillers to give us time to see how things turn out with your tummy,” said Birgitta. “Since you’re fasting, we can give you a couple of Panadol suppositories to insert in your bottom.”
“That won’t help!” wailed Nilla. “I can’t believe Softie’s dead! I want something stronger!”
I bet you do, thought Birgitta.
Softie, that was the dog. Nilla continued to sob pathetically as she exorcised her angst. Birgitta and Anne-Sofie both avoided asking too many questions. They would have to wait, they had all night. They even avoided looking at each other, as it would make it all to clear exactly what they were both suspecting.
“Does anyone in your family know you’re here?” asked Birgitta, and the young patient shook her head. “You know, I have to make a note of a next of kin in case we have to call them.”
“You don’t have to call anyone,” Nilla Söder said curtly.
Birgitta pretended not to hear. “You think about who I can write down, alright? We’ll be back in a bit.”
Twenty-two years old and single, they got out of her later that evening. Nilla Söder hadn’t had contact with her mother in years. She was an alcoholic, Nilla finally informed them. Anne-Sofie’s expression said that she knew of her.
“Nothing’s worked on that woman, she’s a wreck,” she said afterwards when she and Birgitta had exited into the corridor. Out here in the country, the social awareness was great, but the safety net had its holes.
The next time they went to see Nilla, she’d thought about a possible next of kin.
“You could write Adde, but I don’t know if he can afford to buy any minutes for his phone, if you’re thinking of calling him,” she managed.
“Adde. What’s his full name?” wondered Birgitta.
“Andreas Gustavsson.”
Bir
gitta wrote. She also took down the number of that cell phone that was possibly stone dead. Nilla Söder’s address was already in the patient records, although Nilla said it wasn’t right without going into any greater detail about where she usually crashed.
“Homeless, probably,” said Anne-Sofie later. She, who was dependability personified, could not think of anything worse. She rolled her eyes over that fate countless times that evening.
But the way she did it was always so innocent, and she rarely got on Birgitta’s nerves. Anne-Sofie was warm-hearted and if there was work to do, she’d do it rather than simply plonk herself down onto the staff sofa like some apathetic, inert lump, as some people did. Or in front of the computer, the new entertainment center where several of her colleagues would sit glued to the screen as soon as they had a spare moment, playing solitaire or mah-jong, doing quizzes or dreaming of a new home on property sites.
Birgitta didn’t like forcing people out of their chairs and would rather do most of the work herself, which left her both tired and cranky. But there were also those who’d never dream of sitting in front of the computer – they cleared up, emptied boxes, tidies shelves, and generally puttered about. Birgitta wished that the unit manager spent more time out on the wards and less in the office so she’d be more informed about who the time-wasters were; it was her job to give people a dressing down, not Birgitta’s. To go to her behind their backs was unthinkable.
Sofa had another great advantage: she didn’t smoke and so wasn’t forever popping out to the balcony to get “a little fresh air.” All in all, it was a huge bonus to share the night shift with Anne-Sofie.
Birgitta knew that the pleasure was also mutual, and this certainly didn’t make matters worse. All that stuff about personal chemistry was interesting. Anyway, it was wonderful when it worked.
“I’d imagine that Nilla’s had to manage as best she could ever since she was little,” said Birgitta with pity in her voice.
“Some kids have it so tough,” Sofa agreed.
Birgitta felt a sharp sting inside her. She thought of her own grandchildren. True, it wasn’t as if they were going without shelter or clothing; but they were being raised strictly. They were quite simply too well-brought up. She had to take this up with Lotta, she thought.
As the evening wore on, they also found out that Softie had been a mongrel. An Alsatian with much else besides in him, and he was the world’s sweetest dog with lovely brown eyes.
“He just took off across the road. He’s never done that before. Ran right over Döderhultsvägen and never saw the bus.”
Maybe he smelled a rabbit, thought Birgitta. Nilla also has nice eyes. Her heart ached.
Sofa then stuck the ECG under Birgitta’s nose. She called Christoffer Daun and gave him the lowdown, that the gall bladder who was due to go home had chest pains and that she’d had an ECG run on her, but that it wasn’t up to her to interpret it. He asked her to read out the mechanical assessment; it would do as a rough measure but couldn’t be taken as fully reliable. And it didn’t sound alarming.
“She’s sub-feverish with a temperature of 100.2, the Hb has dropped a bit, but the first reading was before the operation and taken venously. Shall I take it again venously?”
“Yeah, that’d be a good idea.”
“But you’ll be up later, right?” she said. “She’s got a headache, too.”
“Let me just clear up down here. But it doesn’t sound too serious. She’s got a healthy heart.”
At least she did earlier, thought Birgitta Olsson. She made a note in the report that she’d contacted the on call doctor and why.
Before the midnight round, Birgitta and Sofa sat down to eat. It was a matter or principle for Birgitta to never eat dinner after twelve, so as not to lose her rhythm. Today she’d brought chicken fillets filled with mozzarella and potato wedges, which she popped into the microwave. She also had a fresh salad in a plastic bag, with dressing and all.
“That looks delicious!” said Anne-Sofie when she saw the food on the plate. For her own part, she had a frozen ready-made Weight Watchers dish that was nowhere near as enticing. After all, it was spring, the time when the hospital staff lived on carrot sticks, cottage cheese, bananas, and fruit salad so as to get into shape for the beach.
They then placed their plates and cutlery in the dishwasher and Birgitta sank down by the side of Nilla Söder’s bed, thinking what it was like when Lotta lived at home, and feeling a pang of yearning.
Nilla admitted that the pain in her stomach had eased off a little and she was calmer. More like normal misery, thought Birgitta.
The patient with the pain in her chest was still not fully recovered, but the worst of the pain had subsided. Birgitta felt stupid and a little duplicitous as she stood there reassuring the patient. She’d called Christoffer again; the time had been half past one, his voice had sounded thick and he’d no doubt been asleep. He’d forgotten to do a round of the ward before going to bed and asked her to read out the ECG again.
“It doesn’t sound so bad,” he said, just as he did the first time. “Let her get some sleep tonight, and I bet it’ll all be over in the morning.”
Yeah, right! Sure, a good night’s sleep was good for lots of things, but not everything.
Birgitta was dissatisfied with his reply, but she could hardly go to the on call room and yank him out of bed.
The breaking dawn found Birgitta and Sofa in the office looking out of the window. They were tired and cold and had pulled their blue hospital cardigans over their shoulders while they looked out over Döderhultsdalen, which was slowly coming to life. There was mist in the valleys and the spruce-covered ridge far away in the backdrop was still darkly toned in indigo. Over in the east was a fringe of yellow-blushed sunlight. The mild sparkles of the morning sun tickling the waves of the Baltic they couldn’t see, merely imagine.
There they stood, shoulder to shoulder.
“My goodness, it’s so pretty,” said Anne-Sofie.
“Isn’t it,” said Birgitta, with serene emphasis.
CHAPTER 11
IT WAS HALF PAST EIGHT, and Christoffer Daun had just filed his report for the night in the radiology unit, where they had their Monday morning meetings. He’d run an apathetic eye over radius and hip fractures and a dislocated shoulder. The orthopedists would be taking a proper look at the X-rays later. Then he just had to file his report. What he remembered of it.
With heavy steps, he made his way back to the unit on the sixth floor. He’d promised to call on two patients before leaving for home. No one stopped him to ask him anything, patients or staff. And she wasn’t there.
He cursed himself. It was far too easy to promise to call patients, and unfortunately just as easy to forget. He hadn’t come up yet with a foolproof system, but he was working on it. The regular telephone hours didn’t stretch that far, not for him, anyway. There were always people wanting to speak to him, mostly women. He was such a good listener, they said. He saw them, they said. When boxes of chocolates and bouquets of flowers came tumbling into the clinic, his colleagues wondered tauntingly what he’d really been up to. Nothing special, he’d say, smiling bashfully. He just took time, looked them in the eye, and listened instead of harping on himself. “Was it really that easy?” wondered José Fuentes.
Yes, it was that easy.
But it wasn’t just a matter of just shutting up. You had to listen with presence, too, thought Christoffer, but it would be totally pointless to explain to Fuentes how to do it. He was a man of big words and wild gestures.
He sat down in the office, picked up the phone, and opened the file where he had Post-it notes with telephone numbers, which he proceeded to throw away. It felt like his eyelids were going to drop like opera curtains. Tired, tired, tired! He envied the colleagues who shrugged their shoulders at night duty. Why was he so sensitive? He wanted to be more robust. Wanted to be made of different stuff.
He heard the phone ringing, but no one answered. He keyed in the cell
phone number. The phone rang again as his foot wagged nervously. He hoped that no one would answer this time, either. So he wouldn’t have to go through with it.
Sleep, heavenly sleep!
The man, a patient of his, finally answered, but had such bad hearing that his wife had to take over. It was about his medication. How was it to be taken? Had he been so unclear when he prescribed it?
“It says on the package,” he said.
“I see,” said the wife, sounding as if she wasn’t quite on the ball.
Christoffer was unsure that they’d sorted everything out when he hung up, but what more could he do than patiently explain? He dictated. Then it was time for the next one. She, on the other hand, answered immediately but asked him to call back in five minutes, and she hung up before he had time to say that it wasn’t possible. Was she on the toilet?
He checked the time. Five minutes, not a second longer. The demands people made these days! Expecting him to sit and wait before calling. Jesus.
What he didn’t know about stress wasn’t worth knowing. Both theory and personal experience had given him thorough insight. He was the man who had run like a mad thing in a hamster wheel. Two years in Stockholm at the main university hospital. For many, it was nothing but stimulating. But all that “positive stress” wasn’t just beneficial. Naturally, negative stress was worse, but pressure is always dose-related, regardless of how pleasant it is. Some people can take more, others less, but an overdose is never without its side effects.
It was an experience to have to acknowledge his limitations at such a relatively young age. His need for rest. That simple need to get a proper night’s sleep, every night. Most people needed six to nine hours of uninterrupted sleep, when their metabolisms had a chance to ease off, their body temperatures to drop, and their pulses and respiration rate to slow.
But what good was it to know that fact if you couldn’t settle yourself down?
For the two years or so he was in Stockholm he’d awakened every morning with the feeling of having to scale a mountain. Again and again. Things got so bad, in fact, that he seriously started to think about the meaning of life in a way that was less than healthy. About how he might just as well put an end to his anguish.
Death of a Carpet Dealer Page 8
