Clinical Judgements

by Claire Rayner

  By the time he’d got to the tinned-fruit-salad-with-tinned-cream stage the others had come in, and he sighed as he heard Sian’s strident voice at the hot plate complaining about the shortage of grated cheese for her salad. If only they didn’t all keep on finishing up on the same shifts, he’d be able to dodge them. It would be so much nicer to be on the same shift as Peter; he always had a funny tale to tell of some sort. In hot pursuit, he was, of the staff nurse on Psych. Nurse Melons he called her because of her boobs, and she didn’t seem to mind, even though he was just a first year. And David sighed and shifted his chair a little as Sian, followed by Suba and a second year he didn’t know, came over to his table. There was no rule that said they had to sit together, dammit; why did they always make a beeline for him?

  ‘You look as happy as a wet weekend,’ Sian said as she sat down with a thump. ‘Can’t be that bad, surely.’

  ‘How do you know?’ David said. ‘We’re run off our feet on Male Medical! We’ve got the Minister for Health in the ward, that’s all, so how can you know what it’s like? You and your piddlers —’

  ‘Garn! You’re not having anything to do with the Minister for Health,’ Sian said and began to eat voraciously. ‘Everyone knows they’ve got private nurses for him. We had a meeting at the Union about it, all this about him being in on the NHS but really haying private nurses from an agency. He’s not going to get away with that.’

  ‘It still makes a lot of extra work for us,’ David said. ‘All the beds shoved together so close because of three being thrown out of his section and all these extra patients that aren’t really ours —’

  ‘What sort of extra patients?’ Sian cocked her head at him sharply. ‘Is this something the Union ought to know about? We don’t have any members on Male Med at the moment — what’s going on there? You tell me.’

  ‘Why should I?’

  ‘It’s your duty,’ Sian said after a moment. ‘Nurses have a responsibility to —’

  ‘Bollocks,’ David said and grinned at Suba. This was better. Having a go at Sian was rather cheering. ‘I don’t give a piss for your Union —’

  ‘I hope you don’t swear like that on the ward,’ the second-year girl who had been sitting murmuring to Suba looked at him. ‘And I’ll teach you to mind your tongue here. Some of us are ladies, you know.’

  ‘How can you tell?’ Sian said and reached for her coffee. ‘All look the bloody same to me.’

  ‘It takes one to know one,’ the second year said smartly and giggled, clearly pleased with herself. ‘I won’t waste my breath explaining to you, of course.’

  Suba, always the peacemaker, smiled at David. ‘I’m sorry you’re so busy,’ she said. ‘It’s horrid when it’s like that, isn’t it? No time really to think about what you’re doing. We’ve been a bit like that, so many operations and all that.’

  ‘Yeah, well, I think one of yours is what’s made us extra busy,’ David said and leaned back in his chair. It had been interesting listening in to what Sister and that consultant were talking about; not that he’d understood most of it, but all the same it was interesting. ‘Didn’t you say Fay Buckland was the name of the consultant on your ward?’

  ‘Yes,’ Suba said. ‘Miss Buckland. She’s very nice, bit sharp to talk to, but likes to tell you things. I was ever so silly, passed out in the operating theatre when she was doing a case, and I felt so stupid — but she came out after when I was sitting getting over it and explained all about why. I knew really — vasovagal, wasn’t it? And standing still where it was so hot and feeling so — well, anyway I did know. But she explained and it was nice of her.’

  ‘Well, she may be nice, but she’s made us extra busy,’ David said. ‘We’ve got this patient who had a brain operation, you see, and —’

  ‘But you’re on Male Medical,’ Sian said.

  ‘What of it?’

  ‘They don’t do operations on medical wards.’

  ‘That’s all you know. We’ve had an arterio-what’s-it done on Mr Saffron, and now we’ve done this transplant thing on Mr Holliday —’

  ‘What transplant thing?’ The second year sitting beside Suba was all attention now, sitting very upright. ‘What are you on about? What’s this got to do with Fay Buckland?’

  David sighed in a rather theatrical manner and leaned forwards resting his elbows on the table and propping his chin on his fists.

  ‘It’s all very easy really. We’ve got in the ward one of these people from Neurology, Parkinson’s he’s got. All shaky you know, and stiff as a board and can’t feed himself or anything. Well, he couldn’t, that was the thing. Not when he came down to us. But then he had his special operation with foetal substantia — well, whatever it was — and now it’s all different. Feeds himself all right, holds the cup and doesn’t spill it, it’s really something. And I heard the consultant talking to Sister and saying something about Miss Buckland finding him the stuff to do it with.’

  ‘I knew it!’ The second year was as red in the face as though the dining room was a Turkish bath, and her eyes were glittering with excitement, and timidly Suba leaned forwards and tugged on her sleeve. ‘Don’t, Shirley,’ she murmured. ‘I mean, it’s not something to talk to David about —’

  ‘What operation did he do? Did he say exactly?’ Shirley ignored Suba completely, concentrating entirely on David.

  He stared at her. ‘I told you he was talking to Sister. I was just there, like. Sorting out the temperature charts.’ That sounded important, so he said it again. ‘I was just sorting out the temperature charts. I was busy and they happened to be there talking.’

  ‘It’s what I told you about, Suba, I saw it in all the papers! Didn’t you? How they take these aborted babies and use their brains to put in old people to make them young again? Oh, it’s wicked, it really is wicked —’

  ‘It’s nothing to do with making him young again,’ David objected. ‘Not as I understood it. It was to stop the shaking and the stiffness. It’s made Mr Holliday much easier to look after, I can tell you that much. But he’s no younger. There’s no operation can do that. He’s ever so old — nearly fifty.’

  ‘Take no notice of her,’ Sian said. ‘She’s got a bee in her bonnet about abortions, this one. Never talks about anything else. It’s very boring.’

  ‘It’s more boring to be a baby that’s killed by an operation,’ Shirley retorted. ‘It could have been you if your mother had been wicked enough. The way so many are now. It’s not having a bee in your bonnet to take a care for babies being murdered. You’re the one with the bee, you and your Unions.’

  ‘That’s for living people, not ones that haven’t even begun to be born,’ Sian said. ‘Some mothers just can’t look after babies and it’s better they have abortions than have any more unwanted babies.’

  ‘All babies are wanted —’ Shirley began but David made a face and got to his feet.

  ‘Sorry I ever mentioned it,’ he said. ‘The way you go on. Anyway, it’s nothing to do with you. It’s a patient on our ward, not yours.’

  ‘It’s everything to do with me,’ Shirley said hotly. ‘If they got the brain they transplanted from a baby they killed in a woman on our ward it’s very much our business. Anyway, it’s nothing to do with whose ward or anything like that. It’s to do with all of us — all humanity.’ And she opened her arms in a wide theatrical gesture. ‘So I shall have to deal with it.’

  ‘You have to?’ Sian stared. ‘You really are full of yourself, aren’t you? Who do you think you are? And what can you do, anyway? You’re a —’

  ‘I’m someone who cares,’ Shirley said and got to her feet. ‘That’s who. Someone who cares a lot. And what I can do is pass this information on to the people who can do something about it. David — that’s your name, isn’t it? You tell me: what else was said about this case? And what —’

  ‘Mind your own business,’ David said uneasily, poised to go. Gossiping when you were off duty about patients on your ward — it was all wrong. The Paw
n had warned them of that in one of their first lectures on nursing ethics. ‘It’s nothing to do with you.’

  ‘But it is, if it was one of our patients who had the abortion, isn’t it?’ Shirley was wheedling now. ‘Go on, David, tell us.’

  He hesitated for a moment, but only for that. It was very agreeable, after all, to have information others wanted, exciting to be able to impart news.

  ‘Well,’ he said. ‘It was a twenty-six-week foetus, I remember that. And he said the uterus was intact so the foetal head was protected — does that help?’

  ‘Oh, yes,’ Shirley said and breathed in hard. ‘Oh, yes! It Won’t help Miss Buckland and your consultant, whoever he is, but it will certainly help us.’

  ‘Us?’ David said uneasily.

  ‘Not you, ducky, and never you think it,’ Sian said. ‘You’ve really gone and started something now. She belongs to that group that spies on hospitals and then makes a great fuss when people have abortions. That’s who you’ve helped. Did you want to?’

  Chapter Fourteen

  ‘It’s out of the question,’ Prue said. ‘It’s the craziest idea I ever heard.’

  ‘Why?’ Ida stared at her sullenly. She hadn’t expected this response at all. When she’d first had the idea, the night they’d brought Prue Roberts in and she’d heard all of them talking and found out about it, it had just come into her head like someone had come and put it there on purpose. Not like an idea of her own at all, just something someone else gave her. Providence if you like. It was meant. And here was Prue being so silly about it even though Ida had taken such care to time her little talk so sensibly, and even though it was obvious it was the answer for both of them. Why not? And she asked again, trying not to sound annoyed, knowing how important it was to be relaxed and calm. ‘Why not?’

  ‘Because — well, because.’ Prue looked flustered and tried to turn away from her, but it wasn’t easy, for Ida was sitting as close to the bed as she could get, and Prue was fixed by the drip still running into the back of her hand.

  ‘But what else can you do?’ Ida said, all sweet reason. ‘I mean you’ve spent all that money and you owe for it, don’t you? I know they done it all wrong, and it didn’t work but you still owe for it. Them people — they don’t just give you your money back, you know, when they make a cock-up. But you’re in a different state over it, aren’t you? You borrowed it and you said you had to give it back —’

  ‘Jerry won’t push me,’ Prue said uneasily and again tried to turn on her side away from her but Ida held on to her hand the way the nurse had shown her the night Prue had been admitted and been so restless and the nurses too busy to sit with her themselves. So Prue had to listen.

  ‘You told me he said it was just a loan. That he needed the money back. And then you said if your Gary ever found out he’d murder you, and take the kids away from you. You said that. So why not do it like I said? It’ll be the best way. You said your husband won’t be back for ages. Well, with a bit of care no one’ll ever know. Your kids are too young to notice and if I get you some nice clothes, big coats and all like that, who’s to know?’

  Prue had stopped trying to avoid her eyes and was staring at her. Her face was a little pinker than it had been, still pinched and with the eyes looking watery and red-rimmed, but she didn’t look like a pallid wax candle the way she had and Ida nodded approvingly at her.

  ‘That’s right, love,’ she said. ‘You must listen to me. You’ll see I’m right. We can fix it easy, and my Tony’ll never know, and he’ll be happy and so will you and so will your poor little baby —’

  Prue’s eyes brimmed and Ida looked over her shoulder anxiously, scared there was a nurse around. She was supposed to be helping with Prue, not making her cry.

  ‘I nearly killed it,’ Prue said huskily. ‘Nearly killed the poor little bugger —’

  ‘You nearly killed yourself, that’s what it was,’ Ida said. ‘That baby’s fine. I made sure of that after I heard ’em talking. I can always find things out, I can, and I can tell you those people you went to, they never did your baby no harm at all. I heard Miss Buckland say. “No harm to the pregnancy,” she said. They just made you bleed something awful, but she’s repaired it, she said, and the pregnancy’s all right. So you see —’

  ‘It can’t be. Not when I bled so much. I’ve been counting the bags of blood they give me. Seven it’s been. Seven pints of blood I’ve had. The baby can’t be all right, not after that.’

  ‘Well, Miss Buckland says it is, and there you are. They wouldn’t say so if it wasn’t, would they? You had the scan anyway. That’s what they did this afternoon, the scan.’

  Prue closed her eyes. ‘Is there anything you don’t know?’

  ‘Not a lot.’ Ida sounded complacent, accepting the compliment. ‘I keeps my eyes to the ground and my ears to the fore, know what I mean? And I think about what I hear and make sense out of it. You got to do something, stuck in here —’

  ‘It’s time you went home, isn’t it?’ Prue opened her eyes again and stared at Ida almost desperately. ‘You said there was nothing more could be done. Time you wasn’t here, if there’s nothing they can’t do.’

  ‘I didn’t say that.’ Ida had gone a dull red. ‘Not at all. I can have some more tests — she’s going to see if I’m right for a test-tube baby, that’s what she’s going to do. They’ve got a project, Miss Buckland said, experimental and all that, but a project. And because I’m willing to be a guinea pig they’re going to let me try. That’s why I’m still here —’

  ‘So if you’re going to have a test-tube baby why did you say what you said?’ Prue still had that desperate air as she stared at Ida.

  ‘I never said I was having one. It’s not that easy.’ Ida looked down at her hand, still fastened on Prue’s wrist. ‘Miss Buckland was very straight with me, very straight she was. It’s a one in a million chance, she said. It probably won’t work. But I can have a go and she’s willing to try for the research. So there’s no promises.’

  ‘But suppose it works? What about me then?’

  Ida leaned even closer, a smile spreading across her face and making her eyes glitter. ‘You’ll do it then —?’

  ‘I never said so!’

  ‘Well, why ask that if you aren’t considerin’ it? Eh? Why ask? Anyway, I can tell you it won’t be no problem. I’ll just tell Tony I had twins —’

  ‘You’re mad,’ Prue said flatly. ‘You’d never get away with it.’

  ‘And how are you going to get away with the state you’re in? Owing all that money and your old man abroad — what’ll you tell him when he gets back, eh? Bet he’ll be pleased when you tell him. “Here, Gary, I got in the club, didn’t I? And I tried to get rid of it, borrowed money and will you give it back to Jerry — you know, the fella I went around with before you what you hates so much — give him back the five hundred quid what I owes him and by the way it never worked, and I can’t get the money back, even though it never worked —” Can’t you just see it?’

  Prue was crying now, tears sliding down her cheeks in oily drips but Ida didn’t care any more. The nurses were on their tea break, half of them anyway, and the rest were busy with that Mrs Walton down the other end who was still so poorly after her operation. No one would notice.

  ‘And here I am with the best idea you’ll ever get to sort it out,’ Ida went on remorselessly, ‘and you turning it down.’

  ‘It won’t work,’ Prue said huskily. ‘It’s crazy.’

  ‘It’ll work. You can have the baby at your flat, can’t you? Or if you like I’ll find another place you can go, a nursing home or something. I’ve got the money, you know My Tony keeps me short of nothing. I got the money, plenty of it. I’ll pay off your Jerry and all the other prices that come in too. All you have to do is what I tell you. It’s no trouble to you at all.’

  ‘But it won’t be yours!’ Prue said. ‘What’s the good of it if it won’t be yours? What good is it to your Tony if it isn’t —’

&nb
sp; Ida’s fingers tightened on her wrist and Prue whimpered and tried to pull her arm away, but Ida held on. ‘You ever say a word about it to anyone, anyone at all and you know what’ll happen,’ she said, and her voice was thin and low but very clear. ‘It’s just between us, whatever happens, just between us. I can make it all come right, and it’s up to me to see it does. And if I do the work then it’s the same as if I had it. I’ve tried everything else and this test tube won’t work any more than any of the other things did. I know that. I’m not daft. So, I’ve got to do what’s best for me, don’t I? And if at the same time it’s best for you, what are you making such a fuss over? Do you want more money? Is that it?’

  ‘I don’t want any money,’ Prue said and then stopped. ‘I mean I’m not selling nothing.’

  ‘Of course you’re not. I wouldn’t ever say such a thing. But if you want more money as well as what I’m going to have to pay out for clothes and for Jerry and all that, well, if I got to, I got to —’

  ‘I owe a good bit,’ Prue said and looked down at her wrist where Ida’s fingers were still clamped. ‘Nearly a thousand quid, it is.’

  ‘Christ,’ Ida said. ‘A thousand? What with — well, I can go to two and a half altogether. No more than that. So that should just about cover it. Will you do it then? Will you? I can’t see what else you can do. You can’t go back to that bloody botcher and get him to try again, can you?’

  Prue seemed to shrink into her pillows. ‘I couldn’t go back —’

  ‘And there won’t be anywhere else you can go. I’ve been around and I know. I’m not stupid, not like some I know. You’re too far gone, aren’t you? That’s what went wrong. You’re too far gone. None of the charities’ll touch you, not after all that fuss about changing the law and all.’

  ‘I didn’t know,’ Prue said and there was a little whine in her voice now. ‘I never show much and I didn’t know. But I kept on being sick and —’