Clinical Judgements

by Claire Rayner

  ‘Not as well,’ she said, and grinned sharply, so that she looked suddenly like a rather wicked little squirrel, ‘not as well as you will.’

  ‘She wants what?’ Kate said and Esther lifted her shoulders expressively and shook her head.

  ‘I agree with you. She’s outrageous. Comes on with all the delicate grace of a crack Panzer division, but there it is. She’s sitting outside there now like Venus on a rock cake waiting to have a word with you about it.’

  ‘You have to give her top marks for cheek,’ Kate said.

  ‘And the rest. Will you agree?’

  ‘I don’t know. I’ll see after I talk to her. Anything else?’

  There was a little silence and then Esther said, ‘Um. Yes.’

  Kate had her head down over her charts and didn’t look up at first, but as the silence prolonged itself she felt the tension and lifted her head. Esther was staring down at her with her face rather red and Kate said lightly, ‘My dear, you look suddenly as though you’ve been stuffed and boiled. Whatever is it?’

  ‘I feel stuffed and boiled,’ Esther said. ‘The thing is, I’ve given in my notice.’

  Kate dropped her pen and stared at her in consternation. ‘No! You can’t!’

  ‘I can and I did,’ Esther said shortly and turned away. ‘I couldn’t stand the nagging any longer.’

  ‘Richard?’ Kate said.

  ‘Richard,’ Esther repeated bitterly. ‘My husband, remember? The chap I tied myself to some time back with a bunch of fancy promises. The bugger I love, God help me.’

  ‘Do you? Or is he just a habit?’

  ‘Do you love your Oliver or is he just good in bed?’ Esther retorted and then shook her head at herself as she saw Kate’s face redden. ‘Shit! I’m sorry, but I couldn’t help it. I’m as mad as hell at him, but he has to be right. They pay me bugger-all here to work my guts out all the hours God gives, and we’ve got two kids and out there there’s money to be made. It’s not the be-all and end-all but, Christ, it comes bloody close to it. With me to organise things properly there’s no question that we can do well, and as Richard says, my first duty is to my own family, surely, rather than this lot here.’

  She lifted her chin and stared down the ward stretching away each side of the nurses’ station; at the humped beds, the tube-tangled machines and the clusters of visitors round each patient and sighed, a sharp little intake of breath that seemed very loud in the small space they were in.

  ‘I mean, look at ’em, will you? They’re dropouts and idiots who’ve ruined their own bodies with all sorts of rubbish and smoking and the rest of it and whatever we do for ’em they’re back in a matter of weeks, no better off and needing patching up again. It’s like that story we were told at school, do you remember? The Augean stables, wasn’t it? However fast you sweep up the crap, there’s twice as much there when you turn round. Well, with Richard there’ll still be crap but at least there’ll be some sort of reward to show from dealing with it. The sort you can show, that is. Cash. Here all I get is a good feeling and a lot of gratitude. Big bloody deal, gratitude —’

  ‘I shall miss you,’ Kate said after a moment and Esther flicked a glance at her and said roughly, ‘Not as much as I’ll miss you, you old bat. You and everything else about this bloody place. Poured my guts out here for years and it’s all I can do to tear myself away. I really must be mad —’

  ‘You’re not mad. It’s the people who don’t think it’s better to give you enough to make staying here more attractive than going off and selling aubergine quiche to yuppies —’ Kate said and reached out one hand to her. ‘Try not to get too mad at Richard. He isn’t entirely wrong.’

  ‘Of course he isn’t! If he was, do you think I’d have agreed? It’s because he’s so damned right that I’m going. Oh, Christ! Aubergine quiche! I suppose it’s not much worse than infected piss and blocked cannulae and meths drinkers in uraemic shock. Not much worse —’ And she grinned at Kate lopsidedly and then leaned over and hugged her and they clung together for a moment or two.

  ‘What’s with you, anyhow?’ Esther said then. ‘That programme was bloody good, you know. I was worried that they’d start on about Kim, mind you. Bloody glad I am they didn’t — but after that little parade last night I don’t imagine you’ll get any more fuss over that chap Slattery. Nice fella he turned out to be, didn’t he? He’s due next week to have his follow-up. Give him my best, won’t you?’

  ‘Are you going so soon?’

  Esther nodded. ‘I’ve got three weeks holiday due to me, and I thought I’d take it out of my notice. Hanging round once you know you’re going doesn’t do. Listen, you’d better go and see your bloody Kim. And Kate — when they start to collect for my present, tell ’em I want something frivolous and deeply personal. If I get any household gear I’ll wrap it round their lousy necks. A huge bottle of joy’d be nice.’

  ‘I’ll tell them,’ Kate said and went to see Kim.

  ‘It was money,’ Kim said. ‘What else? I got to earn what I can when I can.’

  ‘What sort of video, for pity’s sake?’ Kate said. ‘What could possibly pay you enough to make you sign yourself out the day before you were due to go to theatre for your tidy-up? I’ve had to reorganise all the lists, upset a lot of other patients —’

  ‘Porn, what else?’ Kim said defiantly and stared at her. She had even more make-up on than usual today, and looked magnificent. Her hair was tumbling halfway down her back in a richer-than-ever cascade of curls and she was wearing a suit made of mulberry-coloured leather, the skirt so tight fitting Kate winced to look at it and the bloused top lavishly equipped with glittering steel studs.

  ‘They gave me five hundred to show ’em —’

  ‘Show them what?’

  Kim giggled, a high-pitched little sound. ‘My operation,’ she said. ‘What else?’

  Kate stared at her. ‘And now you come back here to ask me to take you in again and still do your tidy-up operation? After that?’

  ‘Why not?’ Kim said and lifted her eyes to stare at Kate. ‘I’ve made sure not to eat or drink this morning. And you know you said it needed doing. You can fit me in anywhere you like, end of the day, anything. And —’ She stopped then and let her over-intense stare drop away. ‘Anyway, you want to. You’re a surgeon. You like to do your job properly. I’m not finished yet, am I? If you don’t take me back, then you’ve let yourself down, haven’t you? And if you thought I was worth dealing with in the first place, thought I was worth taking on, what’s changed? Are you saying I’m a person not worth bothering with because I had to make a few bob for myself in a way you don’t like? Listen, Miss Sayers. It may turn out I’ve got to make my living in the future as a brass. How about that, then?’

  She made a face at Kate’s look of incomprehension. ‘A rotten word, isn’t it? Means a whore, a call girl, a prostitute, call it what you like. I’d be good at it. They don’t all want the usual, you know. A lot of ’em’ll settle for all sorts of other funny business from someone who looks like I do. And I’ve got good muscles. So aren’t I worth bothering with if I have to make my living that way for a while? Till I’ve got enough for my own business again?’

  There was a long silence and then Kate closed her chart and got to her feet. ‘I’ll fix it with Sister,’ she said. ‘I think there’s a bed you can have. It won’t be the same one, but we’ll do the best we can. I’ll do you at the end of the list.’

  And she turned and went.

  Chapter Thirty-Six

  By the time Kate had finished it was past eleven o’clock, and the hospital was settling down for the night with sighs and sudden little flurries of movement, like a great animal. On the Genito-Urinary ward most of the patients were already asleep, although lights burned over the beds of those on dialysis, and she straightened her back gratefully as she closed the last of the charts and said good night to the patient, who just murmured back at her, half asleep himself. Just one last look at Kim to make sure she wasn’t bleeding �
�� that had been a more complex piece of wound toileting than she had expected, because there was some infection there — and then she’d be free to get some sleep. And she stood there in the hall-light of the end cubicle listening to the soughings of the machine and the more distant sounds of breathing from the patients and thought — Shall I just slide into bed here? The overnight room in the doctors mess should be available. A shower, a cup of tea and then I can be asleep before midnight —

  But she knew suddenly that she needed to see Oliver, to feel and touch him. He might even be in bed by the time she got home; he had taken to earlier nights since his beating-up and she thought of him lying there humped beneath the duvet, his legs sprawled wide the way they always were and her skin crept with the need to be there, feeling his skin against hers. It wasn’t a sexual need; that was the last thing she would have energy for tonight. It was much more basic than that, like the desire of a baby for contact with its mother’s warm body. And she stared out of the back window, trying to see beyond her own reflection into the darkness outside and thought — primitive, that’s me, primitive. Wanting the warm pelt of someone reliable and safe to creep into —

  Kim was sleeping heavily, and after standing looking down at her Kate decided not to disturb her, contenting herself with a look under the covers to make sure there was no obvious bleeding into the dressing. She looked different now; the curly hair was tied back in a ragged piece of gauze bandage and the face, innocent of make-up, was smooth and childlike in sleep, even though there were lines to be seen round the eyes and running a channel from mouth to nose on each side. Kate looked down at her, and tried to imagine what she might be dreaming; did she dream herself man or woman? What was it like to live inside a head as soaked in an obsession as Kim’s was? What was it about her personality that made it possible for her to persuade not only Barbara Rosen in the first instance, but Kate herself that she had a real need for the sort of mutilation she had submitted to? And she couldn’t find any answers and pulled the covers back gently over the slightly snoring form and went away down the ward to leave the charts on the night nurse’s desk — who wasn’t far off snoring herself, it seemed to Kate — and make her way home.

  All the way in the car, moving easily and comfortably through the thin midnight traffic, she thought of herself sliding into bed beside Oliver. It became the one thing she most needed, that first soft contact with the smooth firmness of him and his sleepy protests as she slid her coldness against his warmest bits; and she smiled contentedly into the windscreen as the street lights overhead swooped down and then disappeared behind her as she sent the little car bucketing along. It was a pleasure to break the law at this time of night, it really was. And the fatigue that had been threatening to engulf her after what had turned out to be a hectic day stepped back a little and crouched low inside her, temporarily forgotten.

  She was so eager to get to bed with Oliver that she didn’t bother to open the garage and put the car away, relying on the alarm to protect it if anyone tried to break into it in the night, as had happened once before; local people knew she was a doctor and the police had warned her that hopeful drug seekers would make her a regular target, and to lock her car away safely every time. But tonight she was reckless and urgent, and she pushed her key into the lock on the front door to let herself in, feeling as excited as a girl on a first date; oh, but it was good to come home to Oliver, good to be about to crawl in beside him —

  But he wasn’t in bed. She stood in the hall and gazed, startled, at the wedge of light spilling out into the dimness from the living-room door, and heard the faint murmur of the voices from the TV and felt a chill plunge of disappointment. She had made the scenario of how it would be so vivid in her mind that for a moment she didn’t know how to cope, and the fatigue lifted its head and growled at her. But then she shook her head in impatience at herself and dropped her bag and keys on to the chair beside the hall table and went into the living room.

  He was stretched out on the sofa, his head on a pile of cushions and his bare feet propped up on the coffee table, wrapped in his old dressing gown and staring sombrely at the TV screen. There were talking heads there, but the volume was turned down so low Kate couldn’t identify who they were or what they were talking about, and it was obvious Oliver couldn’t either. And she frowned, puzzled, and said, ‘Well. Good morning! Why did you wait up? No need!’

  ‘Mm?’ He stared at her, almost as though he was surprised to see her and then dragged himself upwards, pulling his bare feet off the table and sitting up so that he could rub both hands through his tousled hair. ‘Oh, hello, love. Home so early?’

  ‘Early?’ She almost gaped at him. ‘Idiot! It’s gone midnight!’

  He peered at the video machine below the TV set to see the digital clock there and then shook his head. ‘Ye gods, so it is! I hadn’t realised — listen, have you eaten? Or do you want something? There’s some soup in the fridge — I opened a can and only used some of it —’

  She shook her head. ‘I had operating-theatre sandwiches. Disgusting enough to see me well through to tomorrow. Darling, why aren’t you in bed? You look worn out!’

  ‘Oh, I’m all right. Can’t keep on going to bed immediately after The Archers!’ And he grinned at her, trying to remind her of their silly joke about early nights, and she looked back at him and knew at once.

  ‘What’s happened?’ she said quietly and came and sat down on the sofa beside him. ‘And whatever it is, why didn’t you call me at the hospital and tell me right away? I could have coped, you know, and I might have been useful.’

  He grinned at her a little lopsidedly. ‘Oh, Earth Mother Kate! Knows it all, sees it all, wants to cure it all —’

  ‘Well, what if I do? Isn’t it what I’m for? And anyway — oh, tell me love! What’s happening? Have you heard? Is it likely to be as bad as you thought? Or will they be easy on you?’

  He looked puzzled. ‘What?’

  She could have shaken him in irritation. ‘Do you think it’ll be — will it be a sentence or a fine?’

  He stared at her for a moment and then his face cleared. ‘Oh, that! No, that’s all right. Andrew said they’ve quashed all the charges. He’s got them to repay the bail, the lot. It seems there’ve been a good many complaints about the way this chap’s been handling the demo from the start. And Andrew says that they prefer not to start any dramas. He reckons they know they couldn’t get far — and it might cause internal police problems. No, you can forget all about that —’

  She sat there very still, and then said quietly, ‘When did you hear this?’

  ‘This morning.’

  ‘And you didn’t think to call me and let me share the good news? You didn’t think I’d been frantic over this, even more than you were, and might like to be put out of my misery?’

  He looked at her and seemed to be fighting with a confusion of feelings: shame and anxiety and irritation and something else undefinable. It was the irritation that won.

  ‘For pity’s sake, Kate! I can’t run to the phone every time something comes up! Getting an answer from that bloody switchboard at Old East takes a week and a half anyway. I can’t be doing with it. And I’m telling you now, aren’t I? It’s all right. No need to fret over the thought of me eating skilly and sewing mailbags on Dartmoor. No case.’

  ‘I’m delighted to hear it,’ she said with a sardonic note in her voice. ‘And delighted to see you so happy with the outcome. Turning cartwheels and leaping about in joy and so forth. It’s a real heartwarmer.’

  He was silent for a long time and somehow she managed to sit there and not attempt to prod him into speech. It wasn’t easy.

  ‘Well there — other things came up,’ he said at length. ‘It took away the — it just didn’t seem to matter so much any more — the case, that is —’

  ‘What came up?’ She asked it as coolly as she could, knowing somewhere at a very deep level what it was.

  He got up and went padding over to the door that
led to the kitchen. ‘I’ll make you some Horlicks or something,’ he said. ‘A few tatty sandwiches aren’t enough to see you through the night. You’ll get that damned indigestion again.’

  ‘Thank you,’ she said and made no attempt to follow him, sitting there on the edge of the rumpled couch and listening to him crash cups and pans in the kitchen and feeling the dull sick feeling settle inside her belly, where it lay uneasily alongside the fatigue that still skulked there. But said nothing, waiting as patiently as she could, and at length he came back with a mug full of Horlicks and a plate with digestive biscuits on it, and set them in front of her on the coffee table. She looked down at their homely ordinariness and tears pricked her lids and it needed a lot of control to make sure they were not shed. He could be so caring and thoughtful, so very comfortable and easy and yet at the same time put her through this hell over and over again —

  She lifted her head then and said calmly, ‘Well, you might as well get it over with. What else did Andrew have to say? About Sonia, I mean.’

  His face went a dull mottled red and she sat and looked at him and made no attempt to go to him and touch him and hug him the way she always tried to do when things got painful for him. This time he’d have to manage on his own.

  ‘Is it that obvious?’

  ‘Oh, of course it is!’ She made no attempt to disguise her impatience. ‘I’ve lived with you long enough to know more about you than you can possibly imagine. And that particular look of misery is one that Sonia engineers. And that you allow her to —’

  ‘Kate, let’s not. Please,’ he said and closed his eyes.