Surgeon at Arms

by Gordon, Richard

  Without another word he clattered down the oak staircase and out to his Morris. The sergeant stared after him anxiously. Whatever had happened, it seemed likely to put the brigadier in one of his moods.

  Graham wanted to leave the annex as soon as possible. Tudor Beverley and his staff offered to resign en block, but Graham wouldn’t hear of it. Desmond, who seemed more shocked by his father’s dismissal than by his second stab at paternity, suggested he withdraw from the Blackfriars medical school—the ridicule was liable to break out afresh, he suspected inwardly. Graham told him not to be stupid. His patients suggested getting up a petition, but Graham knew that official minds couldn’t be swayed by even a snowstorm of paper. Anyway, he was suddenly weary of battling with authority. He’d lost, and he wanted to leave the field, just as soon as he could tidy up his work.

  Clare was wonderful. Her practical mind stood rocklike amid their sea of troubles. She decided they would move somewhere for the span of her pregnancy, perhaps up to Scotland. They could enjoy a wonderful holiday until the baby was born—Graham had no need to start work, they’d saved a bit, and she’d a little money of her own. The divorce could surely be left in the hands of the solicitors. Graham agreed with everything. He felt he wanted the child desperately. It would be an achievement, a symbol of defiance, something to show for his existence. Without a regular achievement of some sort, he doubted if he could live at all.

  Then they killed Bluey.

  It was stupid, unnecessary, almost criminal. A couple of years of Graham’s surgery had the Australian looking more or less like a human being. Better still, his hands were mending splendidly. He had a pair of new thumbs made from chips of his hip-bone, he could light cigarettes, hold a tankard, even fondle a girl. A small operation was still needed to trim the inside of his lip. John Bickley again gave an injection, and slipped the rubber tube into his windpipe. To stop the blood from Graham’s incision trickling into his patient’s lungs, John packed the back of Bluey’s throat with a length of oiled bandage. It was common practice, performed on patients every operating day. Afterwards, John drew out the tube and forgot the bandage. They wheeled Bluey back to bed. The nurse who found him dusky and straining to breathe wasted away his life trying artificial respiration. John was summoned, and instantly ripped out the bandage which was suffocating him. But it was too late. Two years in hospital had so enfeebled Bluey that the survior of a blazing Hurricane succumbed to lack of oxygen as readily as a baby.

  John went back to the theatre and told Graham. The surgeon dropped his instruments, left the operation to Tudor Beverley, and strode out to sit alone in his office. John hesitated. He had better face him. At the end of the case he followed Graham to the hut, and found him in tears.

  ‘It was a terrible mistake,’ John admitted at once. ‘I just don’t know how it happened.’

  Graham said nothing. .

  ‘I’m always so careful about the throat-packs, Graham —you know I am. I’ve had nightmares about leaving one in. I’ve been half afraid something like this might come about, ever since the unit started.’

  Graham wearily moved the glass bottle containing the soldier’s tattoo. ‘And after all the poor devil went through,’ he muttered.

  ‘I can’t begin to say how sorry I am.’ Graham again made no response. ‘But it’s awfully difficult, you know, with two tables in the theatre. Without any proper assistants. I’ve told the nurses time and time again to feel for the throat-pack at the first sign of trouble afterwards. The nurse in charge of Bluey was new. She let us down.’

  ‘If you’re going to make excuses, don’t shift the blame on to some poor girl who at the moment is too frightened to speak.’

  ‘I’m not making excuses,’ said John patiently. ‘I’m only putting the facts.’

  ‘Whose responsibility is it?’

  John shrugged. ‘Of course, mine. Ultimately, as the anaesthetist in charge of the case. I’m not denying that.’

  ‘Of course you’re making excuses,’ Graham told him angrily. ‘You’re always making excuses, whenever you make a mess of it with a patient. If you give a perivenal injection, the vein was abnormal. If you break a needle, it was a faulty one. If your oxygen cylinder runs out, you told the orderly to change it. I only hope you’ll find the coroner a more sympathetic listener.’

  ‘I’m perfectly prepared to answer whatever the coroner feels like asking me,’ John retaliated. ‘I've nothing to hide.’

  Graham made an impatient gesture. ‘Oh, you’ll come out of the inquest with your skin. Unavoidable mistake, pressure of work, patient’s difficult airway. You’ll continue with your job here as though nothing had happened. I shan’t even be here to inconvenience you. You and Denise can go on putting out poisonous gossip about me, as much as you care. That probably helped to get me sacked, if you looked into it.’

  ‘It’s not fair to say that, Graham,’ John told him patiently.

  ‘It may not be, but it’s the truth and you know it Denise doesn’t like me. She never has.’

  ‘If Denise has sometimes been... well, indiscreet,’ John admitted, ‘she’s been careful nothing could go further. Not outside the hospital. But now you’re talking as if we were sworn enemies. Of course we’re not. You’re imagining things. Haven’t we been friends, you and I, close friends, for years? Ever since the E.N.T. days? We’ve been through enough together, God knows. We’ve lost patients before.’ He hesitated. ‘We’ve even covered up for each other before. I wouldn’t like to think that, however tragic, this incident meant the end of our personal relationship.’

  ‘Be that as it may, but never in your life will you give another anaesthetic for me,’ Graham told him angrily. ‘At this particular moment, I doubt if that strikes you as much of a penalty. I’m down, I know it. But I won’t stay down. When the war’s over there’ll be fifty anaesthetists in London breaking their necks chasing after my work. I’m going to make my fortune again. And this time you won’t get ten per cent of it. Now please leave me in peace.’

  That night, Clare woke with pain in her back. When she looked, she saw there was some vaginal bleeding. Graham telephoned Mr O’Rory. Then he carried her outside in a blanket, tucked her into the back of the Morris, and drove the ten miles to Smithers Botham. The gynaecologist was already waiting, greeting them with some mild joke about plastic surgeons working at the right end to avoid calls from their sleep. He put Clare into his ward, tipping up the foot of her bed on wooden blocks. He surrounded her with hot-water bottles, ordered an injection of morphine, prescribed doses of bromide, and added well-polished reassurance. ‘Is she aborting?’ asked Graham, outside the ward. ‘Well, now, it’s a threatened abortion,’ Mr O’Rory said amiably. ‘It’s just eight weeks since the end of the lady’s last menstrual period. So it wouldn’t be an unheard-of occurrence at such a time, would it?’

  ‘Could anything have caused it?’ Graham asked anxiously. ‘Mental distress, that sort of thing? You know what worry we’ve been having.’

  ‘Oh, these things happen, they just happen. To tell the truth, none of us knows really why.’

  ‘What’s the chance of saving the foetus?’

  ‘I’d say quite good. Yes, quite good. Though the lady will have to take life with queenly ease for quite a while afterwards.’

  ‘That’s nothing to bother about, nothing at all... ‘And anyway,’ smiled the gynaecologist, ‘the lady isn’t necessarily destined to repeat the performance on a second occasion, is she? If all is lost, there’s plenty more where that one came from. Eh, Graham?’

  Graham began to wonder if he really liked Tim O’Rory after all.

  The bleeding went on. The following day Mr. O’Rory shook his head and said he feared the lady must visit his operating theatre. They gave Clare another dose of morphine and wheeled her along the cold concrete corridor. Mr O’Rory’s anaesthetist administered gas and trichorethylene, they stuck her legs in the air, Mr O’Rory settled himself comfortably on a metal stool between them, and with a curette r
emoved Graham’s latest achievement for good.

  Graham spent the night alone in the bungalow. Depression was no stranger at his side, but he had never known such misery before. Everything was running against him. When he told John Bickley that he wouldn’t stay down he’d meant it. But for the first time he now sensed he was finished for good. He’d never recover professionally. Not when everyone could point to him as the man who was sacked in the war. The child was lost, and in such straits they’d be insane to start another. He wondered if Clare would stay with him. He had really little to offer her, and at her age she must surely expect something rewarding from life. It never occurred to Graham how much she might love him for himself. He always expected to take so much from others, he sometimes felt obliged to offer more than he possibly could.

  Haileybury would not have been surprised at this mental turmoil. He knew Graham’s moods well enough. He was unaware of the pregnancy, and only faintly aware of Clare, whom he had dismissed as another of Graham’s pick-ups. The following morning a car arrived at his mansion, containing a general. Haileybury knew the general well. They had been to the same public school, they belonged to the same London club, before the war they had been off golfing and mountaineering together. The general marched up to his office, saying nothing. He laid on Haileybury’s desk a slip of typewritten paper, which declared simply.

  Pray, why has one of our most famous and able doctors been dismissed his post? The news of his work has vastly heartened men and women in all the Allied Services. He will be reinstated immediately. I wish to know who is responsible.

  Haileybury gave a deep sigh. It was useless to fight Trevose. When they both got to Heaven he was bound to get God on his side.

  ‘Abortion?’ said Mr Cramphorn to Denise Bickley at Smithers Botham. ‘I’ll bet Graham did it himself. With a knitting-needle.’

  CHAPTER FOURTEEN

  IT WAS A GLORIOUS AFTERNOON. The sun streaked the water with gold and warmed the grassy slope where twenty-two-year-old Alec Trevose lay with his face roofed by Sir Robert Muir’s Textbook of Pathology, all 991 pages of it. The slope ran down to a white-painted hotel which had once housed holidaymakers at South-sea, near Portsmouth, but was now a makeshift hospital. Both sea and sky were for once free of men and their machinery, except for an approaching landing-craft, its silver balloon floating nonchalantly overhead, bringing smashed vehicles and possibly smashed humans back from Normandy. By mid-July both the weather and the progress of the invasion had improved noticeably. Montgomery had liberated Caen, the Americans had started moving down the eastward side of the Cherbourg Peninsula, and the coloured-headed pins stuck into maps on the walls of homes all over the country began to lose their faintly worrying immobility.

  Beside Alec on the grass was his sports jacket with leather patches on the elbows, a frayed Blackfriars tie, and a semi-stiff collar. He had cast off his shoes, and his big toes poked through the holes in his socks. His striped shirt was open to display his thin chest—he suffered from asthma, an awkward complaint, liable to grip him in moments of emotion, sexual or otherwise. Alec often put down the asthma to some obscure psychological effect of having been delivered by his own father, the medical missionary, in the Malayan jungle several hundred miles from alternative professional attention. It was the first of many uncomfortable things which seemed to happen to him.

  While his cousin Desmond had gone to a splendid public school, he had attended an odd establishment for the education of the sons of other missionaries, to be reared in a strong atmosphere of piety, chastisement, and carbolic soap. Even the cost of his education was being met by his Uncle Graham (or his cousin, Desmond, however you looked at it), though his bills were thankfully met by anonymous lawyers. He had started the telescoped medical course at Cambridge when the war was a year old. It wasn’t much fun, he reflected, with no one to talk to except potential doctors, engineers, and clergymen, all three professions being thought essential by the Government to ensure eventual victory. But he had seen Cambridge as it should be seen, with King’s Chapel shining in the pure moonlight like an iceberg, Great Court at Trinity a mystery of stones and shadows, Clare College running lightless to the river as a silver screen, the alleys returned to their rightful medieval blackness. It was Cambridge as Newton and Milton had seen it. His tutor was an ancient cleric in a purple stock encrusted with the memorials to countless college soups, who wore both gown and airraid warden’s helmet during alerts, taking seriously his responsibility for the physical as well as the moral safety of his pupils. The science dons had mostly disappeared to concoct new devilment for the enemy. On the whole, Alec thought the University rather superior about the war. It had lived through plenty before with fitting scientific detachment. The church clock still stood at ten to three, and for most of the time honey was off the ration.

  That sunny afternoon by the sea he was still officially studying clinical medicine at Smithers Botham, where he had occupied almost a dozen lodgings in the surrounding countryside. However agreeable his hosts, however tasty the Woolton pie, however hot the officially permitted few inches of bathwater, Alec was always convinced of being happier at the next stop. It was a strange restlessness which applied to his hobbies, his friends, his enthusiasm for the various subjects he studied, and his views of life in general. He had finally asked his uncle Graham to get him into the Emergency Squad. He felt he got on rather well with his uncle Graham. Physically they were much alike, Alec supposed when the family genes had been shuffled at their separate conceptions, they had drawn much the same hand.

  The Emergency Squad at Smithers Botham occupied a low two-storey block which in peacetime had housed the better-class lunatic, who could afford to pay for his own incarceration. It was comfortable enough, it saved paying rent, and you could always risk smuggling in a girl. The Squad’s existence was at last justified on D-Day, when they were abruptly dispatched by lorry across the face of signpostless England to the converted hotel at Southsea, which they found in charge of a Polish civilian doctor who was unable to speak much English, and who seemed uncertain if they were a party of top-flight specialists from London or the men come to mend the boiler. No one knew what cases the hospital was created to take, because none ever appeared. Everyone seemed to have forgotten about them. Their only contact with authority was Brigadier Haileybury, who one afternoon had arrived unheralded to inspect them. ‘I believe I know you, don’t I?’ he had asked Desmond.

  ‘Yes, sir. We met once before the war. In my father’s place in London. My name’s Trevose.’

  Haileybury nodded. ‘Your father is certainly making a name for himself.’

  ‘Deservedly, I hope, sir?’

  ‘Of that I have no doubt. I hope you inherit a share of his remarkable talents, young man. You could look forward to a brilliant career.’

  The brigadier disappeared. They all noticed he had a wonderfully pretty A.T.S. driver.

  Alec slid the pathology textbook from his nose, aware that someone was approaching up the slope. It was Desmond, dressed in a grey flannel suit. His cousin sat down silently beside him, picked a stalk of grass, and stuck the end between his teeth.

  ‘Anything doing in the wards?’ Alec asked.

  ‘No. What are you reading?’

  ‘Muir.’

  ‘I mean this other book,’ Desmond picked up an open volume from the grass. He turned the pages frowning, and after a moment read aloud,

  'Behold me waiting—waiting for the knife.

  A little while, and at a leap I storm

  The thick, sweet mystery of chloroform.

  The drunken dark, the little death-in-life.’

  He tossed the book down and asked, ‘What are you reading that sort of stuff for?’

  ‘It’s too hot for pathology.’

  ‘It’s a rather flamboyant bit of verse, isn’t it?’

  ‘No, I don’t think so. Doesn’t it put a patient’s feelings well? God knows how many think the same thing. They aren’t articulate enough to express th
emselves, that’s all.’

  ‘Nobody uses chloroform any more,’ said Desmond briefly. ‘Who wrote it?’

  ‘Henley. When he was in Edinburgh Infirmary, waiting for them to chop his foot off.’

  ‘Why have you taken to poetry?’

  ‘Why not? Don’t you realize, we’re totally uneducated. All of us. At Blackfriars they simply drown us intellectually in a torrent of facts, mostly extremely dull. What chance have we got to equip ourselves with some knowledge of literature, the arts, philosophy?’ he added , grandly.

  ‘I daresay.’ Desmond bit a piece of grass then spat it away. ‘Unfortunately, they don’t ask questions on those subjects in the finals.’

  ‘I think we should be more interested in being well- 5 educated doctors than getting through our finals.’

  ‘Oh, this is just another of your crazes,’ Desmond dismissed his cousin’s cultural ambitions. ‘I’ve got to go back to London this evening.’

  ‘What’s this? A night out?’

  ‘No, it’s my mother,’ Desmond told him with careful casualness. ‘I’ve just heard. She’s had a stroke. Quite a severe one, I gather.’

  ‘I say, I’m sorry.’

  ‘So am I. But these vascular accidents happen.’ Desmond got up. ‘Shouldn’t you try to find someone to mend your socks?’

  It would never do to display emotion, or even concern, especially in front of Alec.

  The news telephoned from Sussex that morning was hardly a surprise to Graham. For a year Maria’s blood-pressure had been steadily mounting, as she became fatter than ever. He still hadn’t divorced her. The plan had somehow been overlooked in the flurry of his reinstatement at the annex. He told Clare—as he told himself—the episode of his sacking must be taken as a warning. For the patients to continue benefiting from his abilities, he must be careful about publicity in the future. A divorce case in the papers certainly wouldn’t help his standing in the eyes of the Ministry. Such distressing tangles were perhaps best unravelled after the war, when he was his own master again. Clare agreed. The subject was dropped. So was that of a second excursion into pregnancy. Among any affectionate couple the matters never mentioned are generally the important ones.