Life Class

by Allan, Gilli

  Apparently reassured, Carly continued. ‘Anyway, she’s just plain wrong if she’s saying that it isn’t an issue … people coming in who members of staff know. Of course it can be embarrassing. Or worse! This guy came in, I mean, really buff! He didn’t know me from Adam but I knew him. A mate of mine has the hots for him. And he was in here for, well, the obvious reasons. And all I could think about was how my mate wanted to get off with him … if she hadn’t already. After he’d been screened I sneaked a look at the preliminary results from our lab, and later at the results when they came back from “Bacteriology”. Turned out he was OK, though I noticed he’d given a false name and only a mobile number. But if he had been positive for anything, GC, STs, or even worse, what would I have done? What about patient confidentiality?’

  ‘I sympathise,’ Dory said. ‘It’s one of the dilemmas of working in STIs. Patient confidentiality is paramount. You could lose your job for gossiping. Presumably your friend knows you work here? You wouldn’t have to spell it out about her boyfriend. There are ways of hinting to someone.’

  Carly went off to continue her own work. Dory looked blankly out of the window. She recalled telling Fran what wonderful nurses she worked with. True, most of her colleagues were great. Jo Finch was definitely the exception that proved the rule – it was just a shame that she was the one in charge.

  All Dory could now do was wait for the next slides to be brought in to her, knowing who’d provided them. It wasn’t just the identity of the donor that bothered her; it was the connection between him and the man outside. Dory reminded herself again that it was none of her business. She swivelled her stool round to face the two microscopes. At least her attention had been diverted from Stefan’s house.

  ‘Talk about coming down to earth with a …’

  A thump, then the door swung open. Shaskia sidled in sideways, her hands full. She grinned. ‘You talking to yourself, girl?’ In her gloved hands, the nurse carried her patient’s notes and an oblong papier-mâché dish.

  ‘Overworked and underpaid,’ Dory responded. ‘Is that for me?’

  Shaskia looked around exaggeratedly. ‘Don’t see no one else in here.’

  Before taking the dish, Dory swivelled back to the bench and reached for a packet of surgical gloves. ‘So, what’s your verdict?’ she asked, pulling them on. It was the kind of inconsequential query she might have made about any patient whose slides the nurse had brought in for her to analyse. Why did the answer feel significant? The nurse winked an iridescent eyelid, gave a saucy, gap-toothed grin.

  ‘Cute!’

  ‘Not how fit you think he is, naughty girl!’

  ‘But too young for me … and gay, sadly,’ Shaskia added with a laugh. ‘We’ve not seen him before. Claims he’s not an IV drug user and that he’s asymptomatic, which is why I dealt with him. Couldn’t find any evidence of infection, but he’ll be lucky if he hasn’t caught something, given his lifestyle.’ She rubbed her fingers together in the age-old gesture denoting a monetary transaction was involved. ‘Even if the main lab results come back all-clear for HIV, he’ll be recommended a retest.’

  Shaskia pursed her raspberry glossed lips and arched her plucked eyebrows. ‘You can’t have so much sympathy when they’ve brought it on themselves, can you? Opposite of the girl I’ve got next. She says she’s … she was a virgin. Very religious. She was raped, poor soul. The rat convinced her he was a taxi driver.’ Peeling off and disposing of the gloves she was wearing, the nurse left the room. She would be putting on a fresh apron and pulling on a new pair of surgical gloves before dealing with the rape victim.

  Dory swivelled her stool back to face the two microscopes. Irrationally, she was glad that she’d not need the ‘dark ground’ microscope. It was only used if the patient had sores. Swabs were taken of the discharge and the resultant slides were screened for the presence of spirochetes, which indicated syphilis. It was a preliminary screening that, to Dory, seemed an unnecessary duplication, as syphilis was tested for again in the Bacteriology Department.

  The papier-mâché container that Shaskia had brought in contained two slides and a shallow Petri dish. Dory put the slides on a hot tray. She put the dish, a blood agar plate, into the incubator to keep it at a constant temperature until it was collected and taken to the main lab later in the afternoon. Dory wrote down the patient number in her notebook. At this stage, the number was all she usually knew about the patient. Today she had an image in her mind’s eye of the pale boy with the long, dark hair who, as often as not, stood across from her in the life class room.

  Change the subject, she told herself irritably and switched her thoughts to the next patient whom Shaskia had spoken of. Apart from the danger of contracting a sexually transmitted infection, there was a second possibility rape victims were tested for. She wondered what the girl would choose to do if …? Dory shook her head at the complex human dilemmas this work exposed her to. Pregnant. The word resonated in her mind. What would she do? Chance would be a fine thing, she thought ruefully. The boy’s slides should be dry by now. She took them off the hot tray and began to prepare the first for a Gram stain, which would define any organisms that might indicate an infection.

  Minutes later, she fixed the slide in place under the lens and for a moment sat there looking at the microscope instead of through it. In all the years she had done this job she’d never felt less objective. She breathed in. Then she bent her head, lining up the double eyepiece and making minute adjustments to the focus. What she was looking for first, in a high-powered field, were leukocytes, or white blood cells, which would be stained a deep violet colour. These were Gram-positive, and indicated streptococcus or non-specific urethritis. Having examined one field, she re-adjusted the microscope and looked at four more, prepared to count the organisms. Her notebook was beside her to write down what she saw. She wrote nothing.

  She switched her attention to look for organisms stained red, which had taken up the Gram-negative stain. Here, she was looking specifically for kidney-shaped organisms in sets of two – diplococci – which indicated Neisseria Gonorrhoea, referred to as GC. Her notebook remained empty. At length, after carefully studying both slides, her breath was released in a sigh. Dory swivelled her stool to the adjoining bench where the patient’s notes had been placed. Picking up her pen, she filled in the results on the designated form. She would transfer her findings to her ponderous mammoth computer later.

  A revamp of the department had been on the cards for over a decade, offering a purpose-built, multi-million pound building housing modern offices, treatment rooms, and a vastly expanded laboratory. A new computer system had been delayed to coincide with the project. Even before the change of government these plans had suffered a series of nips and tucks. Now, with the whole structure of the health service in question, it looked increasingly unlikely that any part of the scheme would go ahead. Instead of a glitzy new building and a state-of-the-art computer system linked to the main hospital, redundancies, retrenchment, and privatization of anything not screwed down were in prospect. Was Jo Finch the only person who really believed there were going to be changes that anyone working here could welcome? Maybe now was the ideal time to set up on her own.

  When she’d finished writing up the findings, she opened the patient file and added them. So far so good, but this was just stage one. Maybe the main lab’s results would make grimmer reading. He’d never been here before. The screening tests she’d carried out were the first. The only other documents the file contained were the questionnaire he’d filled in and the notes written up by Shaskia, who’d talked to him before she took the samples. Dory resisted the temptation to look through them. She didn’t want the nurse’s remark about ‘lifestyle’ coloured in with any more detail. At least he’d been brave enough to give his real name.

  She closed the file and turned it over. Her eyes dropped to the address. She breathed in. There was a sense of the inevitable about it. No one was keeping secrets. The evidence had been there all al
ong, she’d just been too blind and stupid to see it. Of course that’s where the boy lived. Of course two plus two equalled four. But why should she care? Shrugging, she leant across the desk to place the file with the others. A sudden disorientation threatened her balance, as if her neck was too frail to support the weight of her head.

  Chapter Twenty-two - Stefan

  It felt like he’d been here for hours. He could no longer bear to sit in the car and so for a while he’d been walking around the huge car park, chain-smoking. There was nothing to see, just cars and more cars, and concrete and ugly hospital buildings. Perhaps it was a blessing that the scene was becoming obscured in shadow. Was today the shortest day of the year, or was that yesterday? Surely it was darker than it should be, even for midwinter? Pulling up his collar and hunching his shoulders, he scowled at the inky cloud that had piled back across the sky. Despite his impatience and frustration, he’d had to stay within sight of the front entrance of the clinic, unable even to go for a warming coffee in the main hospital block.

  At last, the slight, black-clad figure – hood pulled up over his head – emerged. He looked towards the car and saw it was empty. Stefan dropped the cigarette and strode quickly towards him. The figure turned away and took a few steps in the direction of the city.

  ‘Dom!’ The boy stopped and looked for the source of the voice. ‘Dom! I’m here. Don’t go.’ Stefan broke into a run. He reached the boy, panting. ‘Bloody fags!’ he gasped. ‘Got to give them up!’

  Dominic looked pale, but then he always looked pale, and he looked angry too. Stefan’s heart dropped.

  ‘What’s up? Was it nasty?’

  ‘It was gross!’ His chin was twitching, his skin goose-bumped, as if profoundly chilled. ‘There was this thing, like a long wire with a loop on the end and they stuck it up …’

  A void opened in Stefan’s gut. ‘I get the picture,’ he interrupted, a chill washing through him at the mere idea.

  ‘And up my bum!’

  ‘I’m proud of you. It’s over now.’

  ‘But it’s not. Fucking waste of time. I’m not doing it again! What’s the point?’

  ‘Why would you have to do it again?’

  ‘I refuse! There’s no way!’

  ‘Calm down.’ Stefan took him by the shoulders. ‘Was it bad news? Tell me what they said.’ But Dom pushed him away. ‘Come on, mate. We’ll deal with it whatever it is. Tell me? Good or bad?’ he tried again.

  ‘I don’t fucking know, do I? Waste of time!’

  Stefan had to clamp his mouth shut. His hands balled into fists and he took a deep breath, desperate to control his exasperation.

  ‘Look, let’s go into town and have a drink, a coffee? We’ll talk it over. I need to understand –’

  ‘You need to understand? I fucking wish I did! I don’t want a fucking drink.’

  ‘Well, a burger and Coke then, anything you want. We need to talk.’

  ‘There’s nothing to talk about. I wasn’t given the results.’

  ‘What do you mean? What the bloody hell was going on in there all this time?’

  It was as if his own anger had the effect of defusing Dominic’s. The boy’s hunched shoulders went down and the tension went out of him.

  ‘Oh, I got the lecture! If you can’t be good, be careful. Like I didn’t know that! But …’ His bleak, angry eyes welled abruptly and he looked away, sniffing and wiping his nose with the back of his hand. He cleared his throat. ‘It’s not that easy, is it? And I was given some results but not … I don’t know.’ The cracks in his husky voice widened. ‘I wasn’t listening properly.’

  Stefan opened the car door. ‘You get in. I’ll try to get some answers.’

  As Stefan loped over to the front entrance, freezing drops of rain prickled his face and hands. He slammed through the door and in the brightly lit interior saw the crystalline formation of snow melt instantly on his leather sleeve. The room was empty apart from a woman sitting behind a desk. Before he could speak, she handed him a questionnaire and asked him to fill it in.

  ‘No! I don’t need … I don’t want this! I’ve come about the … the young man who was just in here. Dominic Barnes. He seems confused. What was he told?’

  ‘I’m sorry.’ The woman’s welcoming expression hardened. ‘We have to respect the patient’s confidentiality. And you are?’

  ‘I’m …’ Stefan paused, wondering how to describe his relationship with Dom. He eventually settled on, ‘His friend. Look, I understand you can’t give me the details. I just want to check that he did get his results. I don’t think he understood what he was told.’

  The woman seemed to consider. ‘Dominic was given some preliminary results,’ she said after a moment. ‘From the screening tests carried out in our own lab. But he wasn’t given the full range of results that he was apparently expecting. He made a bit of a scene, I’m afraid, when he realised that the tests for HIV, hepatitis, chlamydia, and syphilis have to go to the Bacteriology Department at the hospital. Given the Christmas holiday it may be ten days, as much as a fortnight, before …’

  ‘Wasn’t he told this at the start of the consultation?’ Stefan interjected abruptly.

  ‘Of course he was. But when people come in here, they’re often a bit overwrought. They don’t always absorb everything they’re told.’

  Stefan looked down at his shoes. He’d come in here ready for a showdown, but the receptionist’s calm explanation had clarified the situation. He could see it all now. He’d pushed Dom into coming against his will. Dom, having gritted his teeth and gone through with it, had had unrealistic expectations. He’d expected complete and immediate resolution. Stefan slotted his hands into the back of his jeans and looked at the floor. The boy was still so young. He couldn’t bear to live with uncertainty, yet uncertainty was all he’d had all his life.

  ‘And when those tests do come back, even if he is clear,’ the woman continued. ‘It would be advisable for him to be retested. The tests look for the presence of antibodies. However, when the body meets the infection it cannot produce antibodies immediately. We like to operate to a six-month window.’

  ‘Meaning?’

  ‘Negative results, particularly for hepatitis and HIV, refer to the patient’s status three to six months before we do the test. So, I’m afraid, if your friend has engaged in behaviour that might have put him at risk since.’ she glanced at the calendar ‘Well, let’s say the beginning of July, we strongly advise that he come in for a retest.’

  So that was what Dom had meant about “not doing this again”.

  ‘You mean he’ll have to have all the tests again, or …’

  ‘It’s just a blood test,’ she assured him. ‘But the important thing to remember is that all the tests we do are informative, not preventative. If he, if anyone, continues to engage in unprotected sex, then no amount of previous negative results will protect him.’ She raised her eyebrows at Stefan. ‘He has to stop putting himself at risk.’

  ‘For six months,’ Stefan supplied, and nodded at the woman. Only now did he really see her. ‘I understand.’

  ‘It is all explained in plain language in the leaflets he’s been given. And we will, of course, write and inform him of the results when they come back and, if appropriate, offer him the retest.’

  Stefan nodded again and attempted a smile – at least he hoped it was a smile. He was fairly sure something had happened at the corners of his mouth.

  ‘Six months is a long time for someone his age.’ He considered telling her something of the deprivations of Dom’s life. But what was the point? This woman, with her sepia-tinted hair and fashionable glasses that magnified the crêpey skin around her hazel eyes, probably saw hundreds of people a week. She couldn’t be expected to care about one lost boy. ‘I’ll make sure he understands.’

  ‘And, hard though it is, if he does test positive for anything,’ the woman tapped her pen on the desk and looked up at him speculatively, ‘I very much hope you will encourage him, as h
is friend, to do the right thing and inform his sexual contacts of the diagnosis, so that they, too, can be tested.’

  ‘Sorry, Marion. I heard raised voices, but I was in the middle of …’ Initially, the woman who had just entered the room was looking at the receptionist. ‘So sorry to interrupt …’ she said, turning her eyes to Stefan.

  Seconds passed while the information in front of him was digested and interpreted. For the second time in recent weeks the face staring back at him was in the wrong place. Another wrong place! Talk about déjà vu. This was double déjà vu.What was it with the woman? She was intruding herself into his life at every turn.

  Though her expression was one of embarrassed apology, she didn’t look as astonished as he felt. ‘Sorry,’ she repeated and, with a little shake of her head, quickly retreated, pulling the door closed behind her.

  Chapter Twenty-three - Dory

  ‘Happy New Year,’ was said brightly, as soon as she crossed the threshold of the art room. Followed by, ‘Hope you don’t mind me saying, but you’re looking a bit peaky. Hope you haven’t had this horrid flu?’

  Her three-week vacation should have been a time to unwind and relax, to dwell on the scary yet thrilling prospect of receiving a favourable response from Stefan Novak about her offer for his house. On Christmas Eve morning she’d been up in the air, almost euphoric. But by the afternoon her mood had plummeted, remaining at rock bottom ever since.

  It was a continuing frustration that the hospital tests took so long. With up-to-date equipment and an elastic budget, it was possible to turn them round while the client waited. Twenty-four hours, even forty-eight, would be better than the week or more patients were kept waiting by their cash-strapped NHS department. This was a service she could provide if she set up on her own – admittedly, only for people who could afford it. What Dory couldn’t explain, given that she’d found the wait an endurance test, was why she’d stubbornly remained at home. She could have easily put herself out of her misery by ringing a colleague or popping into work and checking the files. It was almost as if she preferred the uncertainty. Her holiday had passed slowly and drearily.