Clinical Judgements

by Claire Rayner

‘I know. I’m not having a go at you. It’s just that — look, I want you to do as I tell you. Take off your gloves and your gown very carefully. Don’t get any blood on your hands, you hear me? Then drop them in this bowl. This one where the swabs are. I’ll take the responsibility for dealing with them. Then I want you to go and wash carefully, especially your face and forehead. Watch you don’t get any of the blood in your eyes. I don’t think you were the target of too much of it — it’s good that you wear such big glasses. But be careful —’

  All the time she spoke her hands went on working, reaching for the needles, setting sutures, tying, snipping ends, making a workmanlike job of the rest of the operation. She kept her head down, but was very aware of the way all of them exchanged puzzled glances.

  ‘For heaven’s sake, Kate,’ Azzopardi said good-humouredly. ‘What a fuss! The boy made a bit of a mess, I know, but what’s a little blood between friends, after all?’

  ‘I — I’ll discuss it later,’ Kate said and let her glance flick upwards for a moment to see them all staring at her. ‘Oh, dammit, I’ll talk to you afterwards. Just let me get this finished, will you? I’m nearly there —’

  Doggedly she went on, setting in the skin sutures at last, making each knot as tidy as she always did, checking that the deeper sutures were firm and finally washing the area down with the wet swabs of antiseptic lotion that were standing ready at the side of the instrument trolley. And then dried the skin carefully and stood back.

  ‘Nurse, you can take off the dressing towels and put on the dressing. Avoid touching the blood. Put the towels in the same bowl as the swabs and Trevor’s gown. Have you any blood on you? Oh, you have. Well, get your mask off and your gown and do the same. Don’t touch the blood and drop them in the bowl. You hear me?’

  ‘Yes, Miss Savers,’ the girl said, clearly mystified, but she did as she was told and Kate stepped swiftly back to give her room as at last the dressing was put on.

  Behind her she felt the door of the theatre open as the porter came in to bring the trolley and get Slattery across to the recovery room. And Kate watched as he was taken away and then slowly took off her own gown and gloves and added them to the pile of bloodstained things waiting to be dealt with. The bowl, big as it was, was piled high and the gowns drooped over to the side to envelop the legs of the stand it was on and Kate thought — I’ll have to clean that too, dammit, and stretched her tired back.

  The door to the concourse was still open and she looked over her shoulder to see what was going on out there, as the last trolley appeared from the next-door theatre with Fay’s last case. On the far side of the big area Kate could see Sister Whelan talking at a great rate with a tall man who was looking a little hunted, and Kate frowned suddenly as she realised he was not gowned and was wearing street shoes. How on earth had someone got this far into the theatres in such unsuitable garb? This security for Saffron was getting to be perfectly ridiculous, she thought; what was Sister thinking of not to push him right out of the area? And she realised then that that was precisely what Sister was trying to do, while the man was stubbornly resisting.

  Fay emerged from her theatre then at the same time as once more the trolley bearing Byford’s case came out of the door of Theatre One into the now very busy concourse, and Kate moved towards the door, drawn to it by the peculiar nature of the situation. There was something very important happening out there and the atmosphere was tense as the nurses and the orderlies moved around on their jobs looking both scared and avid, covertly watching Sister and the man she was berating, and Kate stopped at the door of her own theatre as Fay, pulling off her mask, reached hers.

  ‘Hello, Kate,’ she began. ‘What a bitch of a morning! I thought I’d be here till midnight and here’s me with an antenatal clinic full of vast burgeoning women waiting for me since two o’clock, God help us all —’

  The big man who had been talking to Sister Whelan moved suddenly, sidestepped Sister and came towards the two of them as Byford went pushing past him with his hand on his patient’s wrist. He was lying on his trolley with a face as white and flaccid as the sheet that framed it.

  ‘Miss Buckland?’ the big man said. ‘Could I have a word please?’

  ‘Eh?’ Fay peered up at him a little blearily. ‘What do you want? Who are you? Listen, I’m nothing to do with that Saffron man — it’s Byford you want. Hey, Sister, what’s this man doing here in street clothes, anyway? Don’t we have enough of an infection problem without —’

  Sister Whelan lifted her hands in a gesture of impotent rage as the man said, ‘Not Sister’s fault, Miss Buckland. I tried to explain I’d be willing to wait elsewhere if she would assure me I could see you, and she wasn’t able to give that assurance. So I had to wait for now.’ He reached in his pocket and Kate wanted to laugh suddenly. It was all like something out of one of those late-night films she and Oliver sometimes watched on television on Saturday nights, all stereotypes and comfortable reassuring clichés.

  ‘I’m Inspector Hyman, Miss Buckland, and I would like to have a word with you, if you don’t mind. About a patient of yours, a Mrs Walton.’

  Chapter Twenty-Three

  ‘Did you see it?’ Alice threw herself into the seat next to Sian so hard that she slopped some of the tomato sauce from her fish on to the table, and Sian leaned forwards and mopped it up with ostentatious care.

  ‘You’re a real pig, you know that?’ she said in a conversational tone. ‘Not fit to sit and eat with decent people.’

  Alice ignored her, looking eagerly across the table at David who had been talking to Peter over Suba’s head. She was sitting staring down at her salad and making no attempt to eat it. ‘David, Peter — did you two see it?’

  ‘See what?’ David squinted at her, his face clearly unfriendly. Alice was shaping up nicely to being the most disliked member of the first year, and everyone but she seemed to know it.

  ‘Oh, Christ, you really are dummers, aren’t you? The bloody news, that’s what. In the South East. Comes on after the proper news.’

  ‘Oh, that,’ David said. ‘Yes. I saw it. The demonstrators and all that —’

  ‘Oh, you fool!’ Alice almost howled it. ‘That was at lunchtime. I mean the one that’s just gone out, the six o’clock. Did you see that?’

  ‘Some of us have to work,’ Peter said. ‘We can’t sit around watching telly,’ and he turned his shoulder at her to exclude her from his conversation with Peter and went on talking to him in a quiet voice as Suba still sat silently between them, her head down as she stared at her untouched plate.

  ‘Well, if you don’t know you don’t. You don’t have to be ashamed of it,’ Alice said, hugely pleased with herself. ‘They’ve gone and arrested Miss Buckland.’

  There was a sharp little silence, shocked enough to please even Alice who sat there and looked round at them all with her face glowing with excitement. ‘Did you hear what I said?’ she repeated. ‘They’ve arrested Miss Buckland.’

  ‘No they haven’t,’ Sian said. ‘You’re a bloody fool and a liar too.’

  ‘Well, near enough! It said it on the news — there was a photo of her and everything. Helping police with enquiries into the treatment of a patient here at Old East in the last month and pictures of these people from the group — you know the one I mean. The lot that Shirley Farmer’s always on about. Your mate, Suba —’

  She stopped then and stared at Suba and then leaned forwards and pulled roughly on her arm. ‘Hey, you’re on Gynae! Tell us all about it, for God’s sake. What happened! Did she kill someone? This baby? That was what the woman who was on the news said. From that group. That Miss Buckland killed a baby that could have lived and that it wasn’t just an illegal abortion, it was murder — is it true?’

  ‘I don’t know,’ Suba said after a long moment, with a sharp scared little glance up at Alice and then a shifting of her gaze back to her plate.

  ‘Oh, come off it, ducks, of course you know! I always know what’s going on in Paediatric Ou
tpatients, so you ought to know what’s happening on a little ward like Gynae, for God’s sake! We get hundreds of patients every day and you only have your thirty or so, so you ought to know. Who did she kill? What was the operation? And —’

  Suba still didn’t look at her, and now the others were staring at her too, and David gave her a little nudge with his elbow. It was a friendly enough gesture and he meant no harm but Suba suddenly leapt to her feet and stood almost visibly shaking as she rubbed her arm where David’s elbow had touched her.

  ‘Leave me alone! Just leave me alone! If you don’t I’ll — I won’t let you keep on at me. Leave me alone —’ And she turned and ran out of the dining room as the others stared after her, mystified.

  ‘She didn’t take her dirty plate back,’ Alice remarked after a minute. ‘These Pakis, think everyone’s here to wait on ’em — lazy cow —’

  ‘Shut up,’ Sian said but it was mechanical and she still sat and stared after Suba, her brows slightly twisted.

  ‘Do you think she does know what it’s all about?’ David said and began to wipe the gravy from his plate with a piece of bread. ‘I heard it was nothing much — just the usual anti-abortion lot. Here, I’m still starving. Want a second helping, Peter? I’ll get this one if you get the puddings.’

  ‘Get your own,’ Peter said. ‘I don’t know. Still waters and all that. She’s a funny little thing. Listen, Sian, what time are you off?’

  ‘Usual,’ Sian said. ‘Middle shift. Why?’

  ‘Meet you for a drink after? Over the road?’

  ‘I’m broke,’ Sian said. ‘Stand me a couple and I’ll owe you.’

  ‘Fair enough. Oh, go on, David, get your bloody second helping! Sitting there looking all huffy at me. I’ll buy you a drink too, don’t worry. I’m flush.’ He smirked a little. ‘Would you believe a grateful patient? Went out this afternoon and tipped me a fiver, no less!’

  ‘Unethical, that is,’ Alice Abingdon said, looking up from the plate she had systematically emptied at great speed. ‘You ought to be ashamed. Still, if you’re sharing it, where’ll we meet?’

  ‘Who’s asking you? You’re not wanted. Not now or ever. Come on, David, for Christ’s sake. I’ll go up with you if you’re that shy.’ And the two boys took their plates away to the counter leaving Alice staring sulkily after them.

  ‘Miserable buggers,’ she said. ‘I’ll come anyway —’

  ‘If you do, don’t talk to me.’ Sian got to her feet too. ‘Your absence is much preferred to your company, and the sooner you know it and leave us in peace the better for everyone.’ And then she too went, leaving Alice alone at the streaked and messy table, staring furiously after her.

  By the time Sian got back to her ward the whole hospital seemed to be buzzing with gossip. There had been some talk earlier that afternoon as the news filtered slowly and in garbled form out of the theatres and spread around the hospital gradually and glutinously, like car oil on a cold morning, but the television news had speeded up the whole process. Now there were little knots of people with their heads together in the corridors and in the lifts, and standing around the nurses’ station. And it wasn’t only Miss Buckland’s troubles with the police that were causing most of the talk either.

  It was the rest of the gossip that was worrying Sian the most, and she got back to the GU and looked around for Sister. If anyone would tell her what was going on, she decided, it would be Esther. After all, it was as much in her interests as in everyone else’s; and if she didn’t realise that then that would make it even more clear what had to be done. But Sian had to talk to her first.

  But Esther wasn’t there. ‘Gone to supper,’ the staff nurse said. ‘Now, listen to me, young lady. I told you before you went down for your own meal to get that bed ready in the far cubicle, didn’t I? What the hell were you doing that you left it?’

  ‘Kim Hynes,’ Sian said succinctly. ‘Got an attack of the vapours.’

  ‘Bloody creature,’ Staff Nurse said disgustedly. ‘Listen, you don’t have to sit there and hold her bloody hand every time she gets the miseries. She does it all the time. You’ve got work to do and —’

  ‘Sister said I was to try to help her,’ Sian said virtuously. ‘Not to let her get all worked up. She’s got to go back to theatre to get her wound tidied up and she’d got the horrors over it, Sister said, and —’

  ‘I know what Sister said,’ the staff nurse snapped. ‘Right now, madam, you go and make that damned bed, and let me have no more of your chat. I’ve got work to do and so have you. So get on with it.’

  Sian made a face at her departing back and then went slowly down the ward towards the far cubicle where the beds were waiting to be made up after patients had been discharged. It wouldn’t take that long to sort that out, she thought, and maybe I’ll have a chance to grab Sister as soon as she gets back. I’ve a right to know after all. Don’t I work on this ward too?

  But know what? a little voice inside her asked. It’s not as though you’ve got any facts. Just a lot of talk. And she wished again that she knew some of the people who worked in the theatres so that she could discover the truth of it. But they were such an elite lot, and never talked to anyone but each other, though she’d have risked marching up and asking if any of them had been in the dining room. But they had been conspicuous by their absence, and that too had made her edgy and suspicious. It had to be a matter for the Union surely? How could it not be? And she pulled the bed out to make it and kicked at the phone trolley which someone had left sitting there instead of putting it back in the corridor where it belonged.

  And then stopped and stared at it and laughed aloud and fished in her pocket for a ten-penny piece. Of course that would be the way to do it. And it would be fun to see him again anyway. He was a nice chap, really, and maybe he’d take her to the Chinese again. That really had been a lousy supper.

  Audrey sat beside Joe’s bed, and thought about the possibility of going and having a proper supper downstairs instead of the usual sandwiches they gave her. It was nice of them to give her that much really; after all, she wasn’t the patient. Joe was, and there was no reason why they should put themselves out the way they did. And it was mean of her to be bothered really, with Joe so ill. She oughtn’t to be eating at all, just wasting away the way people did when they were unhappy. But that had always been her trouble. When things were bad they always seemed a bit better when she had something solid inside her. And she looked at the plate of sandwiches on the tray beside her, their edges curled up to show the pallid cheddar cheese inside and knew they wouldn’t help at all.

  She looked then at Joe, asleep as usual on his pile of pillows and felt again the little surge of anger. How could he waste what little time they had left with all this sleeping? Why didn’t he sit there with his eyes open and hold her hand so that they would be together, really together? As it was, it was like he was already — it was like he wasn’t bothered whether she stayed or went, really. And she put out her hand and slid it into Joe’s where it lay on the sheet, yellow with illness and marked with spots of liverish colour and the bronze tinge of the nails and the thumb and forefinger from all the years of smoking his stinking cigarettes; and the length of the nails made her think — I really ought to cut them for him. Or should I just leave him in peace? He won’t care either way, and anyway what’s the point? It won’t be for much longer —

  She shook herself out of that literally, getting to her feet and pulling her hand away from Joe’s so sharply that he stirred a little in his sleep and she stood very still, holding her breath, ashamed to have disturbed him, and him so ill. Beyond her the evening sounds of the ward came thinly in through the curtains, so familiar now it was as though she’d been hearing them all her life instead of just over the past three weeks; the clatter of supper dishes as the last ones were collected and the clink of spoons in saucers as the evening teas and cocoas were taken round and the eternal murmur of the telly set in the distant day room, while beyond that the rattle of
the lifts in the corridor outside the ward and the ringing of telephones and voices and chatter and laughter; and suddenly she wished Joe was already dead, dead and buried and she left in peace to go home to Dagenham and get the cats fed and the garden tidied up, so she could settle down to a quiet evening by the telly. She hadn’t seen a decent film for ages, hadn’t had a decent night’s sleep since God knew when —

  Softly she moved away from the side of the bed, for Joe had not woken, but seemed to be sleeping even more deeply, his noisy breaths escaping his crusted lips in little gusts. He’d be like that for hours yet, she knew. Until the pain woke him up again. He’d had his injection less than an hour ago. She could go and get herself a decent supper downstairs somewhere. He’d never know —

  Sister was sitting at the nurses’ station as she went by and she stopped to tell her she was going for some supper. Sister grunted back at her in an abstracted sort of way, not lifting her head from her writing and Audrey hovered for a moment wanting her to look up, needing her to say the way she sometimes did, ‘Want to talk?’ Ever since that first time when she’d been so cheeky and gone and bearded that Mr Saffron where he sat they’d been on ever such close terms, her and Sister. Audrey took some pride in that. She had no illusions about herself at all: ordinary woman, ordinary family, ordinary background, no education at all really, but she and Sister had got really close. That said a lot to Audrey about herself, that did, so she would say to the darkness in the long nights when she tried to sleep without thinking about Joe. Sister thinks I’m all right to talk to so I can’t be that bad —

  But tonight Sister was too busy, clearly, so Audrey sighed softly and went on her way, taking the lift down to the ground floor where the little knot of special services for patients and visitors were, the flower shop and the paper shop and the little chemist’s, and hoped they’d still have something decent in the café the Friends ran in the far corner. She could go to the hospital’s own canteen, she knew. Sister had told her that; but she didn’t like to really. It was so big and there were so many nurses and doctors and all there and one day one of them’d ask who she was and what right she had to be there, and that’d be awful. The café’d do and anyway she liked to pay her way. It wasn’t too expensive and it made her feel better to pay her own way.