Mrs Briggs, as ever, sat by his side, and though the staff assured Alana the old woman went home at night, she was always there first thing in the morning. Just sitting quietly beside her husband, talking occasionally, but more often simply letting her presence calm the dying man.
‘It’s such a strain on her,’ Alana said later, talking to Will James, the nurse in charge of the four-bed room this shift.
‘Just goes to show you should never do your kids a favour,’ Will said, then he ducked his head and edged away.
‘Never do your kids a favour?’ a deep voice repeated, and Alana swung around to see Rory Forrester standing behind her.
‘Mr and Mrs Briggs. Mr Briggs is in bed sixteen,’ she said, thankful her voice wasn’t behaving as badly as her legs, which were shaking so much she doubted she’d be able to stand. The man had no right to creep up on her and startle her like that! ‘They agreed to let their son and his family move into their house, keeping only one big room for themselves. Now Mr Briggs is dying, there’s really nothing we can do for him that a visiting nurse couldn’t do at home, but the daughter-in-law wants the big room, eventually, for her younger daughter and she doesn’t want Mr Briggs dying in it first. She claims the girl, who’s all of three, would remember and not feel right in it.’
The specialist frowned and shook his head, and Alana regretted her little outburst. Obviously this man felt the same way as the daughter-in-law—or at least felt nursing staff shouldn’t be involving themselves in matters beyond their work.
No doubt he was one of those medical people forever repeating the adage, ‘Don’t get too involved with your patients, as it can impact on your efficiency.’
Though it was her work—that was the whole point. A lot of patients came into Eight B because of lack of care—or caring—in their home situations, and treating them simply for whatever condition they were presenting at the time wasn’t good enough as far as Alana was concerned. Many of these people had to have support systems set up for them before they were discharged, while others, without family to speak for them, needed an advocate to make sure they received the very best of care.
But the specialist was talking, and she should be listening. She caught the word ‘students’ and remembered why he’d come back.
‘I don’t mind students doing rounds with you, or Ted, or any of the consultants who visit the ward. What I do object to is students wandering in and out at all hours and asking patients questions most of them can’t answer.’
‘Because they’re like Bessie?’
The blue eyes bored into hers.
‘Some of them,’ Alana admitted. ‘Questioning someone like Bessie, even about what she might have had for breakfast, can make her more confused. In Eight B we’ve usually got at least two, sometimes up to five dementia patients at any one time. There’s a dementia ward, but it hasn’t enough beds, and so it’s used primarily for younger people with early onset Alzheimer’s, when they reach the stage their family can’t keep them at home. Our patients are usually admitted with other problems as well, and require the attention of specialists who come here but don’t regularly visit the dementia ward. So, really, the patients need to be here.’
The blue eyes studied her as if trying to assess something behind her words, then he gave a little nod.
‘OK, I can understand what you’re saying, but these students are our doctors of the future, and I’ve always believed they should see and understand the progress of patients from their entry through A and E to their discharge.’
‘What they should see and understand is that patients are people!’ Alana muttered. ‘Students come in here with their white coats and officious attitudes which I know are usually caused by nerves. But they are so obviously expecting answers to the questions they ask that the patients try to please them. Then the students leave, laughing before they’re even out of the ward about the old codger who thought his leaky mitral valve had something to do with his bladder. It’s their attitude I object to.’
‘Me, too!’
She was so startled by his agreement she looked up to see him watching her, a slightly puzzled frown drawing his finely shaped eyebrows together.
‘That’s part of what I’m hoping to achieve by introducing them to the admissions ward.’
Alana shook her head, not certain she was hearing right.
‘It’s what you’re hoping to achieve?’ she repeated, then, because it seemed impossible, she added, ‘How?’
‘By getting them to dig deeper, to draw up patient profiles as part of their studies. To look at the whys of illness, and the demographics of hospital patients. Later on in their training, particularly in their intern year, they’re too busy to think beyond the very next minute, but if they’ve had early training in seeing patients as people, a little of that should remain.’
He smiled at her before adding, ‘That’s the phrase I use as well—see patients as people first!’
The smile was so unexpected, and lit up his face so vividly, she had to blink away the brilliance. But blinking had no effect on the melting sensation the smile had caused in her bones.
Melting bones and Rory Forrester? Oh, no, definitely not! she told herself as he moved to a phone on the other side of the horseshoe of desks to respond to a page. They might both be in agreement over the ‘patients as people’ issue, but she doubted whether the students would change their ways, and she knew she would still have to fight him over it.
She had also, rationally and carefully, worked out that love, should it come, would grow out of friendship, and mutual respect, and a host of other practical things that had nothing to do with melting bones.
Melting bones were signs of lust, and lust only led to dangerously unsatisfactory relationships.
Hello, Alana! First you’re stuck on a profile you see in a dark theatre for a few minutes—and perhaps the dry-cleaning fluid in his suit—now, two days later, your thoughts are leaping from lust to relationship with a man you’ve only just met? A man who is probably married. A man you’re prepared to fight on just about every issue he wishes to pursue.
A man who uses a bone-melting smile as a weapon!
Puh-leese!
She slumped into a seat in front of the computer, trying to concentrate on work—and wondering, as she often did, when work, i.e. nursing, had turned into a computer-based career. Bessie Oliver…She checked the latest info from the social work department—possibility of a bed at a nursing home, miles from where the woman currently lived with her granddaughter.
Alana phoned Prue.
‘I really don’t want her to have to go. She’ll hate it. You know how she is in hospital—always wanting to go home.’
‘But, Prue,’ Alana said gently, ‘the home she wants to go to isn’t your place anyway. It’s the home where she grew up. Wherever she goes isn’t going to be that particular home. So, really, it’s up to you. Would visiting her at Belltree Gardens be possible for you?’
‘I guess so. It’s a fair drive but once I’ve got the kids in the car an extra twenty minutes doesn’t really matter. And I could visit at night sometimes when Bart’s at home to mind them.’
Alana was about to give a thumbs-up of triumph when Prue spoke again.
‘But I feel terrible about it, and if I go to visit her and see she’s unhappy, I’ll feel worse. I promised Mum I’d look after her.’
Alana sighed, but not so Prue could hear her.
‘How about you go and look at Belltree? Today if possible. I’ll lie and say we’re definitely taking the bed, because if we hesitate someone else will snap it up. But, remember, look at the place from the point of view of how it’s kept, whether the staff seem cheerful and competent, if the patients seem tidy and well cared-for. Bessie isn’t going to be really happy anywhere, I think you know that. What you’ve got to consider is whether she’ll be looked after as well as you can do it, or not.’
There was silence for a moment, then Prue conceded her point.
‘I’m
not doing it very well at the moment,’ she admitted. ‘And you’re right about her not being really happy anywhere. But it’s so sad—so pathetic really. She was such a vibrant, intelligent woman and she’d hate to think she’d lost her dignity the way she has.’
‘But she doesn’t realise it,’ Alana assured the worried woman, crossing her fingers behind her back, because sometimes she wondered if dementia victims actually were aware of what they’d lost.
‘Telling lies?’ a fast-becoming-familiar voice murmured, and fingers lightly flicked against hers.
Alana stiffened, partly because the slight and fleeting touch had produced a reaction more in keeping with being prodded by a red-hot wire and partly because she’d been caught out in such childish behaviour.
By a man with whom she’d barely drawn up battle lines.
Somehow, she finished her conversation with Prue, then she turned to where Rory Forrester was leafing through the patient list.
With his profile clearly lit by light from a window beyond him.
CHAPTER THREE
ALANA’S heart thudded to a halt, then resumed beating, but erratically.
It couldn’t be! And even if it was, you can’t fall in love with a profile. You settled all of that. And all the girl talk about Mr Tall, Dark and Handsome taking the seat beside hers at the concert had been just that—girl talk!
Fantasy!
And it was dark in the theatre—how do you know it was the same profile? Rory Forrester obviously hasn’t recognised you!
‘Is this a fairly typical Eight B population?’ he asked, and, realising she was still holding the receiver in her hand while her mind whirled confusedly along foggy byways, she set it carefully back in its cradle and tried desperately to understand his question.
He waved the list towards her.
She straightened her spine, told herself she knew the answers and that, of course, her lips and tongue would still work no matter what her heart was doing, then answered—carefully.
‘I haven’t checked the details of every patient on the list today, but we usually have about six to eight patients with pneumonia query chest infections, about four patients with other infections—bladder infections or cystitis being the most common of them—then always a couple of badly ulcerated wounds—usually on legs.’
She frowned as he flipped the page over.
‘You probably realise a lot of our patients are elderly and many of them have been living on their own or with equally elderly partners. They manage daily tasks just fine, and the majority of them lead full and interesting lives, but they haven’t grown up in a “seeing the doctor” culture and tend to let minor irritations, like a sore leg or a bad cough, go for a while until the infection reaches the stage where only hospitalisation and IV antibiotics will help.’
‘I do realise that,’ the man said calmly, while his eyes told her to go teach her grandmother to suck eggs.
An overwhelming urge to hiss and spit at him crept over Alana and she knew exactly how Mrs Phillips’s cat must feel.
‘Dehydration, sometimes from an intestinal upset but also from a poor fluid intake, is also a common reason for admission.’ Curbing the impulse to react, she continued her explanations—confining it to basics and hoping maybe she could bore him out of her space. ‘Then stomach complaints themselves, if severe, and breathing problems—we generally have up to half a dozen asthma or emphysema patients at one time, and a range of query-type patients. Query kidney stones, query gallstones, query ulcerated intestines.’
She looked directly at him, ignoring the fact that the blue eyes were affecting her nearly as badly as the smile had earlier. Thank heavens the profile wasn’t also on view.
It was because he was new, and she was worried about his effect on the running of the ward, that he disturbed her.
The physical reaction was simply an extension of that worry, and nothing at all to do with T-shirts kept in plastic bags.
‘Does the ward work well?’
‘Yes!’
Blunt answer to a blunt question, but then she remembered the days it didn’t work well and felt compelled to elaborate.
‘Most days!’ she added. ‘And when it doesn’t, it’s not the fault of the nursing or ancillary staff but the medical staff. We see a lot of specialist consultants, who are supposed to come in before their specialist outpatient appointments. I realise things happen and often they can’t come, but at a certain stage during an unexpected call, or during their outpatients appointment list, they should have some idea of when they’ll finish and be able to give us a rough idea of when they’ll finally get here.’
The dark brows drew together.
‘Why? So you can make sure the bed corners are all tucked in properly? Didn’t that type of rigid inspection go out in the ’fifties or ’sixties?’
Alana hoped Rory Forrester could recognise a furious glare when he saw one.
‘It’s nothing to do with bed corners, although the sheets stay tauter and the patients are therefore more comfortable if the beds are properly made,’ she snapped. ‘It’s to do with the patient and his or her family. The specialist makes the decisions about the patient’s treatment, yet the patient and his or her advocates rarely get an opportunity to see the specialist. A visitor might, if he was lucky, get to see a junior doctor—someone who can’t answer questions like “How long will Grandma be in?”, “What are you testing for now?”, “Why choose this particular treatment?” The interns and residents do their best, but most patients, or their advocates, want to see the boss.’
The mobile eyebrows rose.
‘Really? It’s been my experience that it’s harder to interest the family—and often the patient as well—in the treatment and reasons for it than it is to get spare beds in the dementia ward. Most people simply don’t care. They send Grandma to hospital and wait until they’re asked to take her home.’
‘What a revoltingly cynical attitude!’ Alana snorted. ‘Shows how rarely you specialists see real people—most of whom care a great deal for Grandma and want to understand what’s wrong with her.’
She shrugged then added, ‘Of course, once someone starts an explanation with a healthy injection of medical jargon, the listener can get lost, but that’s the fault of the specialist, not the patient’s relative or advocate.’
‘Do I detect a note of antipathy towards specialists in your voice, Sister Wright? Is your opinion of their behaviour perhaps weighted by your own attitude?’
‘If it is, it’s an attitude developed through experience,’ Alana told him. ‘I’ve worked on this ward for seven years now, and believe I’m qualified to give an opinion about it.’
Rory Forrester gave her a slow smile, then raised an elegant, slim-fingered hand.
‘Any number of opinions, apparently,’ he murmured. ‘On student rounds, length of patient stays, specialist visits…’ He ticked off the list on his fingers. ‘Have you any other issues you’d like to air?’
Supercilious attitudes might be one, Alana thought but a voice page was now summoning Dr Forrester to Ward Eight C, so she didn’t get the opportunity to mention it.
He made polite apology noises and departed, leaving her feeling frustrated that she’d had the opportunity to speak to him yet had somehow been sidetracked so nothing had been resolved.
All in all, he was just as aggravating in person as she’d imagined he would be.
Though far better-looking than the photo in the staff newsletter had suggested.
Which led to her wondering if she’d kept a copy of that particular paper. She generally leafed through them then used them to line Stubby’s litter tray, or shredded them for nests for Biddy. But because she’d known he was going to impact on her working life, she had a feeling she’d kept the issue.
She shuffled through the papers in her drawer but, apart from a few old and very squashed chocolate bars and half a packet of gum, nothing of any interest came to light.
Had someone pinned the photo on the ward noti
ce-board? Was that where she’d seen it recently?
She was about to hit herself on the head for even considering ways of sneaking it off the board when a voice, thankfully, interrupted her thoughts.
‘You said Dr Wallace would be here by eight. I’ve already waited two hours.’
The justified complaint from a young wife anxious to see the specialist about her husband’s kidney test results turned Alana’s full attention back to work. Though she felt a momentary regret that Dr Forrester had left—she could have sicced this woman onto him!
‘I’m sorry, Mrs Cheevers. Dr Wallace was expecting to do his round before he saw his outpatients, but he was unavoidably held up.’
Teeth gritted behind her false smile, she made a mental note of another aggravation she should bring up with Rory Forrester. Lying to protect the specialists who didn’t let the ward know when they wouldn’t be coming in.
‘After all,’ she fumed to Daisy, when she unexpectedly met her neighbour in the queue at the hospital canteen at lunchtime, ‘all they have to do is phone the switchboard—or even get someone else to do it for them—and have an “I’m unavoidably delayed” message sent through to the ward. Is that so hard? Is politeness so old-fashioned now that no one cares?’
They shuffled forward, Daisy making noncommittal noises, which, now Alana thought about it, was Daisy’s usual way of dealing with uptight friends.
‘What are you doing here anyway? I thought you’d got rid of all your hospital sessions and were concentrating on your talk-back show, web site and books. Don’t tell me you’ve left the talk-back show already?’
‘No, but I’m thinking seriously about it—though I’d keep the web page going—and I have got rid of hospital sessions. But I still take on a few private patients and needed to talk to one of their—Oh, there he is. Over at the far table on the left. Rory Forrester. Have you met him yet? He’s taken the flat above yours.’
Alana looked more closely at her friend. Daisy was the calmest, most placid person she knew. Verging on dead, she was so unemotional at times. Yet the disjointed explanation she’d just offered was not only flustered—it didn’t make sense.
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