“It was the cliff road, Sister,” he said, his voice thick with embarrassment. “Far as we can tell, she missed that right bend near the Crown, right at the top there, and hit the wall – how she didn’t go right over was a miracle –”
“I see.” Barbara’s voice was low. “Does Geoffrey – have you told her husband?”
“We’ve only this minute found who she was –” The policeman held out Mary’s smart handbag, looking incongruous in his big red hand. “Shall I ’phone now? or p’raps you’d rather –” His voice died away, and he looked at her helplessly, clearly bewildered by the turn events had taken.
Barbara shook her head decisively. “I think you had better call him,” she said clearly. “I must stay here. There’s work to do –”
“No!” Mike’s protest was sharp. “My dear, you can’t look after her yourself. I couldn’t let you – it would be too unkind –”
“I’m the only trained nurse here,” Barbara said levelly. “The nurses on duty are all cadets and untrained staff. And you can’t manage on your own.”
“Matron –”
“ – is staying overnight in London. So that’s that,” Barbara said crisply. “Look, we’d better put her in that empty private room. The radiologist can take her films there, and it’s next door to the theatre. I think we can move her on this table – unless you’d rather she stayed here?”
Mike pulled himself together. “No, you’re right. She’ll be better in a bed. I’ll put up a plasma drip as soon as we get her settled. Josephs should get here soon –”
Almost like an automaton, Barbara set to work. Together she and Mike trundled the heavy Casualty table along the darkened corridors; together, they lifted Mary gently into the narrow white bed in the little single roon next to the operating theatre. And while Mike himself prepared the equipment for the intravenous infusion of plasma, the little nurse and Barbara gently undressed Mary, bathed the white face, and arranged the room.
Afterwards, when Barbara had sent the nurse to make a round of the other patients, and she stood alone in the room, looking down on her sister’s still face, the white bandage hardly more white than the cheeks below it, she tried to collect her thoughts. This was Mary, she told herself. Mary, her own sister. But somehow, the rush of feeling she ought to experience just didn’t come. She felt numb, and somehow no more involved than she would be if this patient were a complete stranger.
“But she’s desperately ill,” she told herself. “She might die –” but even this thought couldn’t rouse her. Barbara rested her fingertips lightly on Mary’s wrist, finding the uneven pulse, frighteningly rapid. “She’s bleeding –” she thought. “And her unconsciousness is deepening. Intra-cranial haemorrhage –”
Behind her the door opened. The radiologist, a young woman whose eyes were still a little fogged with the sleep she had been woken from, trundled the big portable X-ray machine into the room. Barbara stood back, and watched as the girl arranged the metal plate that contained the film under Mary’s head, watched her set the apparatus, heard the buzz as the film was taken – and still felt nothing. No fear, nothing but a dumb acceptance. Since that first wave of horror had spread over her at the first sight of Mary, since it had gone, she had been like this. Quite unfeeling.
Mr. Josephs arrived as the girl took the film away to be developed. He nodded his grey head at Barbara, and with Mike close at his side, leaned over the bed.
There was silence as his long fingers removed the temporary dressing Barbara had put on, and gently touched the wound and felt the bone behind it. He listened to Mary’s chest, took her blood-pressure and pulse, and then straightened up with a little grunt.
“Don’t need an X-ray to confirm this,” he said, his voice loud in the silent room. “Shattered like an egg shell. I’ll try to clean it up, and get the splinters out, but it’s a poor hope – she’s bleeding fast – have you got any blood for her?”
“I’m just going to start some plasma, sir,” Mike said nervously. “Then I’ll cross match – but I thought I’d better get the drip going first. I was just about to start when you arrived –”
Mr. Josephs nodded. “Mmm. She’d be better off at Dover, of course, but I doubt if we’d get her there. Relatives informed? They’d better be warned – she won’t do much –”
“Sir –” Mike interrupted, his face agonised with embarrassment. “Sister Hughes here – the patient is her sister –”
“Eh?” The surgeon looked up sharply at Barbara, standing quietly beside the bed. “Good God – I say, I’m sorry, Sister! I’d no idea – you shouldn’t be looking after her yourself, should you? Too much strain for you – she’s so ill!” He turned to Mike, his face angry. “For Christ’s sake man, what are you thinking of? Send for another nurse, will you, even if Sister is on duty here! You can’t expect her to –”
“There isn’t anyone else, sir.” Barbara’s voice cut across Mike’s attempt to explain. “I’m the only trained nurse on duty tonight. And I’m quite able to cope, thank you. Please don’t worry about me.”
Josephs stared at her under his grey brows, and then nodded. “I see, my dear. Well, I’m sorrier than I can say about this, but I must warn you – she is extremely ill.”
“I know, sir,” Barbara said quietly. “I would be grateful if you would speak to my brother-in-law when he comes. I don’t think I could manage that –”
“Of course, of course, my dear –” He touched Mary’s pulse again. “Sister, I’d like to operate in as short a time as possible – can you – I mean can you –” he floundered.
“I was Theatre Sister at the Royal for some years, sir.”
His relief was almost comical. “Were you, by George! Well, well! What are you doing in a cottage hospital then? – Beg pardon, m’dear. Impertinent of me – none of my business.” And he almost blushed.
The little nurse from the private rooms slid nervously round the door. “Sister –” she whispered. “Mr. Martin is here –”
Mr. Josephs looked up sharply. “Your brother-in-law, m’dear? I’ll see him now –” and he hurried from the room, his face settling again into his original stern lines.
“Nurse –” Rapidly, Barbara gave the little junior instructions. “Stay here with the patient, will you? Take her pulse every ten minutes, and chart it here. I’ll set up the theatre, so I’ll be right next door if you’re at all worried. I won’t be any longer than I can help. Doctor Foreman –”
Mike hurried round the bed to stand beside her, looking at her with almost ludicrous concern.
“Will you be good enough to manage this drip on your own? And when it’s up, perhaps you’d go along and see Mrs. Innes for me – she’s in coma, so there isn’t much we can do. But I’d be glad if you’d look at her.” Barbara made for the door, pulling her cuffs off as she went. “Sorry to leave you like this, but I’m the only one who can get the theatre ready –”
As she snapped the lights on in the tiny theatre, and hurried into the tight cap and mask and gown, she felt the first moment of fear for Mary. The surgeon clearly thought she would die.
But then, as she set about the familiar tasks of preparing the theatre, filling the sterilisers with bowls and dishes, getting out the instruments, laying out gloves and dressings, she reminded herself of the old Hippocratic maxim. “No head injury is so slight that it should be ignored, nor none so severe that life should be despaired of.”
She was ready in half an hour. The theatre bustled into life. Mike and the nurse from the private rooms brought Mary in, and Barbara helped to lift her on to the table. Then, as Josephs and Mike scrubbed up, and the junior nurse stood by ready to tie them into their gowns, Barbara, her fingers moving delicately and smoothly, cut away the hair round the hideous gash on Mary’s forehead. As she clipped away the black hair, so like her own, except for the lines of white in it, she shivered a little. Mary couldn’t possibly die, she assured herself. Not the efficient Mary.
By the time she had herself scrubbed up
, and come to the table, smoothing the thin brown rubber of her gloves over her fingers, the men had towelled up. Across the theatre, the anaesthetist who had come from Dover with the surgeon frowned over the faintly moving respiration bag on the machine. Barbara noticed, almost automatically, that he was giving no anaesthetic, only oxygen. “She’s too deeply out already,” she thought. And then she turned her attention to the work before her.
Mr. Josephs, forceps held poised in one slim brown hand, peered at her over his mask.
“You’re sure you can manage, Sister?” he asked gruffly. “It’s a dreadful strain when the patient is an acquaintance, let alone a close relative –”
“I can manage, sir,” Barbara said evenly. “Will you be needing burrs?”
His eyes creased in a tight smile. “Good girl,” he said. “No burrs yet. Explore first,” and he bent his head to the towelled shape in front of him.
The little room settled into an uneven quiet. Barbara could hear the faint hiss of the anaesthetic machine, the occasional clank as the anaesthetist knocked the oxygen cylinders, the click of instrument against instrument. The nurse hovered nervously in the background, her eyes strained and scared as she avoided looking at the area where the surgeon’s fingers probed and explored.
“Poor little monkey –” Barbara thought, as she broke open the tubes of fine silk and catgut sutures. “I should have spent more time with her before, telling her what to do – she must be terrified –” but she couldn’t spare more time to think about the nurse. Josephs was having trouble. She could see the fine beads of sweat forming on his wide forehead, the tight lines of strained concentration on his face, as he tried desperately to remove the splinters of bone that were embedded in the soft tissues of Mary’s brain.
When it happened it was so sudden that Barbara had not time to think. A sudden spurt of vivid red blood stained the front of Josephs’ gown just as the anaesthetist called out, his voice shrill with anxiety “ – she’s stopped breathing – can’t find a pulse –”
Even as Josephs tried desperately to find and stop the tear in the bleeding artery, Mike pulled the sheet back from Mary’s body, and with an outflung hand almost shouted at Barbara, “Knife – I’ll try a heart massage –”
They worked desperately. Mike, with a skill Barbara would not have expected in so newly qualified a man, opened the chest, deftly, and with steady even movements, massaged the heart. For a moment, the blood pulsed feebly in the head wound, and then the pulsation stopped, settling down to a slow oozing that showed that the heart was no longer pumping blood round the still body on the table. Frantically, the anaesthetist pumped away at the respiration bag, in a vain effort to fill the lungs with oxygen.
But even as she worked, giving Josephs swabs and forceps, filling a syringe with a heart stimulant for Mike to inject direct into the heart muscle, she knew it was too late. Mary was dead. Dead.
Almost at the same moment, the three doctors faltered in their work, and stopped. They looked at each other, and then Josephs pulled his mask wearily away from his face, and looked at Barbara.
“I’m sorry, Sister,” he said dully. “It was – almost inevitable,” and he gently pulled the sheet back across the wound in Mary’s forehead, covering her completely. Mike, without raising his head, pulled his gloves off and dropped them on the floor.
Josephs came round the table, and put his hand on Barbara’s shoulder where she stood silent and still in her place.
“Come along, my dear,” he said gently, and with a firm pressure led her out of the theatre into the ante-room beyond.
She stood there for a moment, swaying a little with fatigue. Without thinking about it, she noticed the clock on the wall in front of her, automatically noting the time of death for the record she would later have to make. Five-thirty. Was it so long since the little nurse had come to Mrs. Innes’ bedside, and told her she was wanted in Casualty?
She could see the first lightening of the morning sky beyond the windows, heard the early stirrings of the hospital outside the door. It was morning, a spring morning, and Mary was dead.
She took a deep shuddering breath. Then, almost to her surprise, she heard her own voice:
“I must go to the ward. There is a patient there –”
“Never mind that.” Josephs sounded brusque, the brusqueness of sympathy. “They’ll have to manage without you –”
She shook her head. “I must go. Mrs. Innes – she’s dying –”
He bit his lip, and then with an almost imperceptible shrug, dropped his hand from her shoulder. “Yes – I daresay you’re right. I’d want to work, too. I – I’ll speak to your brother-in-law now.”
The women’s ward was rustling with movement, scattered pools of light showing over beds where patients had woken early. One of the patients on her way to the bathroom padded past Barbara where she stood in the doorway.
“Morning, Sister,” she yawned. “Goin’ to be a nice one – bit of sun to come, I shouldn’t wonder –” From behind the screens round Mrs. Innes’ bed, the older nurse from the children’s ward appeared, carrying the chart that usually hung at the foot of the bed.
She padded over to Barbara, and looked anxiously into the shadowed white face.
“Mrs. Innes – she died about half an hour ago, Sister. I’ve sent for Doctor Foreman to see her and write the certificate and all –”
Barbara stared at her, uncomprehendingly. “Mrs. Innes – died? Mrs. Innes – ?”
And then the tears came, hot and harsh, tearing her weary body till she shook. She hardly knew why she was crying. It was morning. There was a bit of sun to come. Mary was dead, and Mrs. Innes had died half an hour ago. And Barbara wept like a baby, leaning against the wall where the patients couldn’t see her, mourning for something she hardly understood.
Chapter Eight
The sun poured across the drawing-room, lighting the deep purple of the couch into a rich pool of colour. There was a thin layer of dust on the low bleached coffee-table, and the thick lilac rug beside it was rucked and crooked. Automatically Barbara leaned down and pulled it straight.
“You – you won’t make strange, now, will you Barbara?” Geoffrey’s tired voice sounded thin and uneven. “We – the children and I – we would like you to visit us as often as – as often as you care to –”
Barbara looked up at him, at the narrow shoulders in their stark black covering, at the vivid white of his shirt against neat black tie. She couldn’t look at his face.
“No, of course not, Geoffrey. I’ll visit you all as often as I can. How – how is Josie today?”
He shrugged. “Much the same. I can’t get a word out of her. Doctor Maxwell has given me some sedative stuff for her at night, and it seems to have stopped the nightmares. But I wish she’d – show something –”
Barbara nodded. In the week since Mary’s death, Josie had said little, speaking only when it was unavoidable. Each night she had woken screaming from nightmares, to cling desperately to Barbara who came running in to her from her own room across the corridor. But in the morning again, she behaved as though Barbara and her father were strangers, pulling back sharply if Barbara happend to touch her in passing, sometimes staring at her father with lack-lustre eyes that held a glint of – was it dislike? in their pale depths.
Jamie’s response to the news had been more orthodox. He had wept the agonised tears of the adolescent boy, stormy tears, but once this was over, he had seemed almost himself. He had retreated a little more perhaps into his private life, spending long hours at his friends’ homes, but his attitude to his father remained unchanged – cool and friendly, accepting him as a man who had his own affairs to concern him, slipping easily into a comfortable male relationship that seemed to hold little of emotion in it.
“Jamie will be all right,” Barbara had thought, watching him, smiling back as he caught her eye in a friendly little grin. “But Josie – Josie is taking this so badly –”
Barbara remembered, unwillingly, to
o much of what had gone before: Josie’s bitter outburst against her mother, the way she had wished her mother dead – the possibility that she had seen and heard too much of what had happened the night of the party – the argument Barbara had had with Mary on the very last time they had spoken to each other – had Josie heard that? And she would push the memories away, confused and rather frightened, just as she had pushed away the thought of herself in Mary’s place –
She stood up sharply, and still without looking at Geoffrey, spoke rapidly:
“I’ll be going back to the hospital today, Geoffrey. Mrs. Lester will be moving into the attic flat with her husband this afternoon. She’s used to the house, so it shouldn’t make – make too much difference. I mean –” she floundered for a moment, and then recovered. “She should be able to run the house quite smoothly for you. If you need me at all, you’ll let me know?”
“Yes – yes, thank you, my dear. It’s been very good of you to stay for this week. I’ve appreciated it. I don’t know what I’d have done without your help – so many people at the funeral –” He grimaced suddenly, his face creasing with pain. “Poor Mary – She’d have hated to think – but I suppose it’s a good way to – to go. Not knowing anything –” There was almost a question in his voice.
“She couldn’t have known anything,” Barbara said gently. “Mr. Josephs said that too. Don’t worry about that, Geoffrey.”
He walked across the room to stand staring out across the sunlit garden. “I sometimes think this was my fault,” he said abruptly. “If I hadn’t been so wrapped up in work, perhaps she wouldn’t have spent so much time with those damn committees. If I’d been better company, she mightn’t have gone to a meeting that night – It might never have happened –”
“Don’t be stupid!” Barbara’s voice was sharp. “Mary lived the life she wanted. She was happy. She wanted you to work as you did – and she enjoyed her committee work. Blaming yourself is ridiculous. And it won’t help Josie, either. She – well, I think perhaps she, too, is feeling a sort of guilt – and she will need all the support you can give her now.”
Cottage Hospital Page 8
