Clinical Judgements

by Claire Rayner

  Oliver stood with the rest of them at the Casualty entrance of Old East, the heavy Uher slung on his hip, and hoped with all the fervour he had in him that she wouldn’t happen to come past. Not that he didn’t want to see her at every possible opportunity, of course, but this was different. The last thing he wanted was any of these other people thinking he had a special ‘in’ to the place. Bad enough he actually had it; it would be no good thing if everyone knew it.

  If only he’d realised what he was letting himself in for when he’d agreed to help old Radlett out; but how could he have done? There was the man tearing his fair hair with frustration when Oliver came out of the studio after finishing his programme and of course he’d asked him what was wrong; anyone would. And the old man had seized on him and that had been that.

  ‘I know you’re a big name star around the station and all that, Merrall,’ he said in that rattling staccato speech of his. ‘But you’re still a bloody journalist and I need a journalist so bad I could kill for one. Who’d be a fucking news editor on a station like this, with two daft girls and a lad straight from university for a staff? But there it is — I’m arse over tip in big stories, and now this. That man Saffron is being admitted to hospital this afternoon and swears he’s an NHS patient, but we’ve had a tip-off he’s getting such fancy treatment he might as well be in the bloody Wellington or whatever. Everyone’s doorstepping, of course, but we could clobber the lot of them and get a piece into the six o’clock if we could get someone there with a Uher. And even if you can’t get an interview, a nurse or two; perhaps see if anyone’s got any views on Health Ministers who abuse NHS services — you know the sort of thing —’

  ‘Hey, I’ve got work of my own to do, Radlett!’ he’d protested, but he knew the old bastard had won. As soon as he’d come out with that line about Oliver being a star on the station he’d known he was defeated. It was the worst thing anyone could call him; Radlett knew it made him squirm, and that was why he’d said it. If only he could be like that chap on the Beeb who was no bigger a pull than he was — his own ratings were far higher, dammit — but who had no shame at all about exploiting it, it wouldn’t be so bad. He, Oliver, had never opened a supermarket or taken part in a TV panel game, for Christ’s sake. That bloke had; yet it was Oliver who when accused of being a star immediately capitulated and agreed to stand in for one of Radlett’s half-baked journalists who were scattered around London on other stories.

  I must have been mad, he told himself gloomily now, to let myself be so easily manipulated, and he stood at the back of the crowd praying that Kate would not appear. If he’d realised in time that it was Old East that was the hospital in question he would have pulled out, no matter what Radlett said or how many times he taunted him with so-called stardom; but there it was, he’d got the Uher on his shoulder and his brief ready when the newscar driver had told him where they were going, so what could he do? Not a damn thing —

  There was a little wave of movement through the crowd of journalists then, like a wind blowing over a cornfield, and he followed as they turned as one body and headed for a long black car that had just pulled into the yard.

  ‘Mr Saffron,’ someone was yelling as the car door opened. ‘Mr Saffron, can you tell us why you are here, please sir —’ And then other voices took up the cry and there was a whirr and click of cameras as the driver got out of the car.

  But it wasn’t Saffron and they retreated, irritated, as a tall figure in a dark suit came out of the door of the Accident and Emergency department so fast it was as though he’d been shot from a gun.

  ‘You people, move away — move away at once — you are trespassing!’ he shouted and waved his arms about officiously. ‘You have no right to be here at all, no right — go away at once.’

  The journalists turned on him, again moving as a single entity as though he hadn’t spoken. ‘Mr Byford, sir,’ one of them called, the thin chap from the Dispatch who seemed to know everyone in sight and who had appointed himself the press pack’s spokesman. ‘Mr Byford, is Mr Saffron to have —’

  ‘I won’t have my patient tormented like this!’ Byford said loudly and his face was red with the effort of speech. ‘Now go away at once,’ and at once the journalists crowded closer as the Dispatch man rained questions at him, and the black car behind him remained stubbornly closed.

  ‘Mr Byford, is Mr Saffron suffering from heart disease?’ Clearly the Dispatch man knew all about Byford and his speciality, Oliver thought, and switched on his Uher. He might as well get what there was, even if it was too blurred and noisy for transmission. ‘Is he to have one of your operations, sir, the ones you’re famous for, the catheter clearance of the coronary arteries? Has he had a heart attack, sir? Is he at risk of severe illness? Is —’

  ‘No comment!’ roared Byford and tried to push past them to the car, but the Dispatch man stopped him by simply standing in his way.

  ‘It’d be a lot better, sir, if you agreed to a press conference, you know,’ he said. ‘We’re here now and we can’t go till we’ve got the story, can we?’

  Someone had emerged from the far side of the car and now was pushing his way through the crowd and as soon as the Dispatch man saw him he pounced.

  ‘Mr Welsh! Good to see you — we need a press man here — look, can we have a statement? We’ve got some of the story so you might as well —’

  The thin man, in an overcoat that looked ridiculous in this warm August weather, leaned over to speak in Byford’s ear and then stood up and nodded frostily at the journalists.

  ‘Press conference in the Boardroom in half an hour,’ he said shortly. ‘And after that we’ll consider the possibility of one or two of you coming up to the ward to see for yourselves the arrangements. As long as you go now and let Mr Saffron be admitted quietly without all this fuss. Hardly right when he’s a — when a man isn’t at the top of his form, is it? No — so the Boardroom, first floor Admin building, half an hour. Mr Byford has agreed to be there.’ And he looked enquiringly at Byford who, after a moment or two, nodded. ‘Is that reasonable, gentlemen?’

  Clearly it was, for the pack moved off, with some hesitation on the part of the Dispatch man who led the way, and Oliver followed after a moment, thought not before he noted the way the photographers had drifted only a short way away and were ready with their lenses trained on the car door to get a picture of Saffron as he emerged.

  Well, that was reasonable enough, he told himself as he followed the rest of them towards the Admin building. The great greedy maw of the presses have to be fed with their bloody pictures, never mind the words; thank God I’m a radio man. It’s got a little dignity left to it, though not much. And he walked with his head down, praying he wouldn’t meet Kate.

  He didn’t, and he settled himself in the Boardroom near the front, accepting the courtesy the newspapermen usually offered to the recording people, and set up his microphone and organised in his mind the questions he’d have to ask if no one else did; and waited, trying not to think of what had happened the other night. At least being here and being busy helped to push it away. But not for long.

  Why had he done it? Did he have to let Sonia drive him so mad? Did he have to dance so willingly to her bloody piping and upset Kate so much? And his eyes got hot as he thought of Kate and her patience with him. He’d behaved abominably to her, he knew that. She loved him in a way Sonia never had, without any of that profit-and-loss accounting that had been Sonia’s trademark on every transaction in her life, from childhood on: if I do this for you, what’s in it for me? She had used the same yardstick for their lovemaking even, when they’d been married, trading kisses and caresses against cash and status. He knew it now even if at the time he’d been too besotted to realise it. And yet, knowing it, he had still let her do it, still let her make her hateful bargains, chaffer like some damned beggar in a market place — and a soft sound escaped his throat as he thought of how it had been the other night.

  He had picked up the papers he had told
Kate he was going to fetch from the studios — that had been true enough at least — and was on his way back to the car when he’d been stopped by some old man with a tale to tell, and he’d tried to listen to him but been so desperate to get away to make sure he spoke to Sonia that night that he’d been short with him and had just seized the envelope the old man had pushed into his hand and then legged it for the car, leaving him disconsolate on the kerb. He felt bad about that as he remembered; it had always been his way to be polite and kind to the fans, even though they irritated him so much. They had a right to approach him, after all; didn’t he come into their living rooms, their bedrooms, their bloody lavatories even, at the turn of a switch? He had no right to be rude to them. Yet he had brushed off that old man just so that he could go and see Sonia to beg her again to let him have his children on a regular basis; and as he had put the car into gear and pulled away he’d looked back through his rear-view mirror and seen the old man staring after him and felt like a shit. But it hadn’t lasted. He had gone to Sonia and —

  But that was not to be thought of; and he thrust his hands deep into his pockets now as he tried to push away the memory of what had happened, and how once again she had checked him and fiddled her bloody bookkeeping to make sure all the profit was on her side; the bitch, the hateful screwing — and he pushed his hands down even deeper to stop the words coming into his mind.

  And then pulled out the right hand, and looked down at the crumpled paper in it. It had been in his pocket and he’d forgotten it and he had a sudden sharp memory of the old man standing on the dark kerb and staring after his car as he pulled away, and felt again the rush of guilt. He’d given him no further thought, and here was his letter. It had been in his pocket like this for almost a week.

  And he made a face at himself and smoothed out the envelope and then slit it open and took out the carefully written letter inside.

  Chapter Nine

  Kate came clattering down the stairs from the second floor of the Admin building, rather pleased with herself. She knew they’d taken off more tax than they should have done as soon as she’d got her payslip last month and, generally speaking, trying to persuade those people in Finance they’d made a mistake was like trying to walk over a ploughed field in high-heeled shoes, but this time they’d admitted their mistake at once and promised to rectify it, so she felt rather good. It was absurd; even completing a tricky case smoothly didn’t give her as much satisfaction as showing an administrator he was wrong. And she grinned at herself as she went past the big open doors of the Boardroom and glanced in as she went by. It was full of people, and she wondered briefly who they were and what they were doing and then went on down to the ground floor and out of the building, forgetting them as soon as she had seen them. She had other things to think about.

  The ward when she got there was hectically busy and Esther could do no more than give her a distracted ‘Good morning’ as she hurried past her in the corridor. Le Queux had a theatre list this morning and the patients were positively whizzing in and out of the theatre and into their beds from Intensive Care as he made the usual whirlwind exhibition of himself. Keith Le Queux, some of his colleagues sometimes commented sourly, drew his surgical inspiration from the nineteenth century; he valued his work in inverse ratio to the amount of time he spent on it. The faster the operation, as far as he was concerned, the less important the outcome. But then, as Le Queux was fond of saying, ‘They would say that, wouldn’t they?’, because Le Queux enjoyed a singularly large and successful private practice, which few of his detractors could match for income.

  Kate was glad he was operating. That would mean she wouldn’t have to see him and she made a small face at herself as the thought came into her mind. It shouldn’t be so. They were supposed to be colleagues, albeit with herself very much as the junior partner, and that meant they should be on good terms, especially since they shared a speciality. But that just wasn’t possible for Kate. The man patronised her, that was the trouble. He would smile at her and be exceedingly polite but Kate knew, none better, when she was being categorised and dismissed as a ‘little woman’ and it made her exceedingly angry. Not least because there was nothing she could get hold of, no accusation she could level against him, no way in which she could find a lever with which to shift his maddening behaviour to a more reasonable mode. She just had to let him get away with it, and try not to grind her teeth too obviously. So, it was much easier when she didn’t see him.

  Her round was a smooth and easy one this morning and she was happy to do it with the junior staff nurse on duty, so leaving Esther to cope with the Le Queux burdens, and she went from patient to patient, talking, checking wounds and dressings, reading charts and path lab results and reassuring the ones she could and comforting those she couldn’t. This was in many ways the best part of her work, she thought, the direct contact with patients. Operating was dramatic of course, full of the pleasure of technical skill, the exercise of intellect and judgement, the source of considerable adrenalin highs, but dealing with people who were far less predictable than the behaviour of blood gases or the routes of nerves and arteries deep inside bellies — ah, there was the real excitement, even if it wasn’t the heady operating-theatre brand. And she ended her round and sent the staff nurse away feeling relaxed and pleased with herself. All these years of work and struggle to become a consultant; there had been many times she had wondered if the time and the effort and the sheer concentrated bloodiness of it all was worth while. This was one of the occasions when she had no doubt at all.

  ‘I’ll see Kim Hynes on my own, Staff,’ she said now as she passed over the list of charts and took Kim’s from the stack. ‘I’ll need to talk for some time and I don’t want to hold you up. How has she been?’

  ‘He’s been all right,’ the staff nurse said, a little pointedly, and slid a glance at her from beneath lowered lids, and some of Kate’s pleasure in her morning’s work slid away. Oh, damn it all, why had she agreed to take on so complicated a patient? He belonged with Barbara Rosen, not with her. If only he could be nursed on her psychiatric ward after surgery, how much easier it would have been. And then she bit her lip, annoyed with herself for thinking of Hynes as ‘he’. Barbara had been rather strong on that.

  ‘You must regard her as much as a woman as she does herself, Kate,’ she had said. ‘Unless you do, you’re going to have major problems in dealing with her.’

  And she had tried, very hard, but it wasn’t easy. So she had no right to be annoyed with the staff nurse’s unspoken but clearly intended criticism. And she watched the girl march away down the corridor back to the nurses’ station with a small sigh, and then turned and went into Kim’s section of the ward.

  It was one of the basic four-bedded units, pleasant enough though cluttered with the equipment surrounding the two beds nearest the window, where both patients were in dialysis. Esther hated having to put any other patients in there, but it was hard enough to make full use of the units available with dialysis machines without deliberately leaving spare beds unused. If the unit could afford all the machines it needed it would be different, as Kate well knew, but as it was, she had to accept that sometimes patients had to be mixed up in a fashion that was far from medically ideal, and that included mixing patients of different genders as well as different therapy needs.

  But Kim seemed happy enough. She was sitting up on the bed, wearing a kimono in very soft pale green trimmed with what appeared to be white fur but which was, on closer inspection, clearly synthetic, and looking at it Kate thought how cheap it looked and knew it had cost a lot of money. Clearly Kim didn’t stint herself of the frillier things in life. Her slippers, which lay negligently on the floor at the side of the bed, were pale green satin and very high heeled with the same furry trim, and her bedside locker was laden with bottles of make-up and perfume and hairspray. She was sitting with one foot carefully poised on the bar at the end of the bed, painting her toenails a rich scarlet, and looked as perfectly turned out
as if she were on her way to a ball. Her mass of tinted red-gold hair was curled and waved and beautifully arranged inside its shell of lacquer and her face had the porcelain perfection of a Vogue advertisement in full colour.

  ‘Good morning, Kim,’ Kate said, and stood there looking down on her, and at once Kim looked up and flashed a wide smile.

  ‘Oh, Miss Sayers, I’ve been so looking forward to seeing you! I thought you’d never come — have you come to tell me when we meet in the theatres?’ And the smile widened even more.

  ‘There are things to talk about,’ Kate said. ‘Would you prefer to come down to the treatment room? A little quieter there —’ and she looked briefly at the other patients by the window.

  ‘Oh, that’s all right!’ Kim trilled and flashed her wide smile at the other women. ‘We’ve no secrets here, have we, girls? They understand — this is Mrs Antrobus, Miss Sayers, and this is Jenny and this is —’

  ‘I know,’ Kate said and nodded at the others. ‘This is my ward, after all.’ And Kim bit her lip and made a little moue of embarrassment.

  ‘Ooh, I am silly! Do forgive me — it’s just — well, you know how it is in hospitals. Like ships they tell me. You get ever so close to the people you share with, ever so quickly. We’re close, aren’t we, girls? So you can say anything you like to me in here, truly you can.’

  The other women said nothing, staring from their pillows with dull eyes at Kim in her exotic green kimono and Kate thought — She’s working so hard at all this, at being one of the girls. It’s so sad, to work so hard and for such a purpose — and looked at Kim.

  ‘I’m sure you’re on excellent terms with your — er — room-mates,’ she said in a low voice. ‘And you’re right — it does happen in hospitals that way. But all the same I think I’d rather speak to you in the treatment room. So, if you don’t mind —’