A Wife for Dr. Cunningham

by Maggie Kingsley

  ‘’Strewth, but I look like Long John Silver,’ the man exclaimed with dismay as he got off the trolley and looked at himself in the mirror.

  ‘Be grateful you’ll eventually be able to see out of that eye,’ Hannah replied. ‘Riding a motorbike without goggles might be considered macho but, believe me, losing your eyesight isn’t.’

  ‘Yeah, right. Thanks for your time, Doc,’ he replied, zipping up his leather jacket. ‘And I’ll remember what you said about the goggles.’

  She doubted it. He’d probably be out on his motorbike in a couple of days, still not wearing his goggles, and end up back in A and E with something considerably more serious.

  Cynic, her mind whispered. Too damn right I’m cynical, she thought. Cynical, and jaded, and depressed.

  She was so tired, that was the trouble. Not just physically tired—that she thought she could have coped with—but mind-numbingly, brain-sappingly tired, and yet she’d only just come on duty. Only just arrived for the start of the night shift with another eight long weary hours to go.

  How did Robert, and Elliot, and Jane work here day after day, night after night? Where did they get their inner resources from, or had her father been right all the time when he’d said she didn’t have the temperament to become a doctor?

  She’d thought he’d been wrong. She’d been determined to prove him wrong, but now…Now, she honestly didn’t know any more.

  ‘Ah, Hannah, my dear!’ Mr Mackay, the consultant in charge of A and E beamed as he breezed down the treatment room towards her, with Robert at his side. ‘I need your opinion on the patient in cubicle 1. Woman in her mid-fifties, brought in by her husband because of excruciating pain in the upper left quadrant of her stomach. She was sick after dinner tonight, and brought up some blood.’

  Opinion be damned, she thought wearily as she stared up at the consultant’s cheery face. Mr Mackay had plainly just realised she’d been with them now for over two months and he was trying to find out whether she was up to scratch or not.

  The symptoms he’d outlined indicated that his patient might be suffering from a bleeding stomach ulcer. It probably was a bleeding ulcer, but there was no way she was going to make any snap diagnosis in front of the consultant.

  ‘Was there a lot of blood when she was sick?’ she asked.

  ‘Not a lot, no.’

  ‘And the colour of the blood. Was it bright red, or very dark?’

  ‘I believe the patient said she thought she’d merely brought up some coffee until she realised it was actually blood.’

  Hannah nodded. Many patients with slow-bleeding ulcers said their vomit looked exactly like coffee grounds.

  ‘I’d do a guiac test,’ she said firmly. ‘If she’s bleeding from a stomach ulcer—which I strongly suspect she is—her stools will look black and tarry, and that will confirm the diagnosis.’

  ‘You’ll be pleased to know that it did,’ Mr Mackay said, his smile widening. ‘I’ve got young Kelly Ross sitting with her at the moment, but if you could pop in occasionally, to check there’s no change, I’d be most grateful. She’s going to have a long wait for Theatre, you see—apparently they’re really busy tonight.’

  Well, bully for them, Hannah thought sourly as the consultant walked away. And so much for Mr Mackay wanting her opinion. As she’d suspected, he’d simply been testing her, and at midnight on a busy Friday night she could do without someone examining her medical ability.

  Slowly she began to walk down the treatment room only to discover to her surprise that Robert came after her.

  ‘You did very well just then,’ he said approvingly. ‘Being grilled by a consultant in the middle of the night isn’t the easiest thing in the world to handle.’

  ‘No,’ she murmured.

  ‘And you took your time over the diagnosis, didn’t say the first thing that came into your head which can always be a danger when you’re put on the spot,’ he continued. ‘I’m really proud of you.’

  ‘Yeah, well, thanks,’ Hannah said without enthusiasm.

  He shot her a puzzled glance. ‘Are you OK, Hannah?’

  No, she wasn’t OK. She hadn’t been feeling ‘OK’ for quite some time now, but not for the world would she ever have admitted it to anyone, far less to the special registrar.

  ‘I’m fine, thanks.’

  His gaze swept over her. ‘So those dark shadows under your eyes, they’re some new sort of fashion statement, are they?’

  If he was trying to be smart, she didn’t appreciate the joke. If he was showing true concern, she didn’t think she could handle it right now.

  ‘It’s the fluorescent lighting in here,’ she said tightly. ‘It would make even a beauty queen look rough.’

  It was true, it would, but Robert knew only too well that the fluorescent lighting couldn’t possibly make her look even thinner now than when she’d first arrived two months ago. It couldn’t make her face seem to consist of nothing but a pair of huge, dark eyes. And it most certainly couldn’t give her a face that was paper-white and strained.

  ‘I’d say you were anything but fine,’ he declared. ‘In fact, I’d say you were working too hard.’

  ‘No harder than anybody else,’ she protested.

  Yes, but none of us seems to be as driven as you, he wanted to reply. None of us seems to be constantly trying to prove something, and he couldn’t for the life of him think why. She was a good doctor, a dedicated one, and she had nothing to prove, least of all to him.

  He tried again. ‘Hannah, nobody would be surprised if you were finding working in A and E very stressful—’

  ‘Are you saying my work isn’t satisfactory?’

  There it was again, he thought in confusion. The stricken look he’d seen on her face many times before. The instant assumption that he was criticising her.

  ‘Your work is perfectly satisfactory—in fact, considerably more than satisfactory,’ he replied, frowning with annoyance as he noticed Elliot coming towards them. ‘All I’m saying is, if you ever feel you need help—advice—ask for it.’

  ‘I will.’ She nodded. ‘If I need it.’

  She wouldn’t, he thought as he watched her hurry away. There was something in her that seemed to consider asking for help a sign of weakness, something that made her see an offer of help as a sign of failure, and if she wasn’t careful he very much feared she was going to grind herself into the ground.

  ‘Something wrong with Hannah?’ Elliot asked curiously as he joined him.

  ‘She’s doing too much,’ Robert said in exasperation. ‘She looks like a ghost, and she won’t accept help.’

  ‘I seem to recall Hannah’s predecessor—Dr Jarvis—being exactly the same,’ Elliot observed, ‘and I don’t remember you offering to hold his hand. In fact, I thought you said “Good riddance” when he left.’

  It was true, he had, but Robert didn’t much care for the knowing, amused smile on the SHO’s lips. The smile which always seemed to appear on Elliot’s face whenever he voiced his worries about Hannah.

  ‘It’s not the same thing,’ he retorted.

  ‘Yeah, I can see that.’ Elliot grinned, and before Robert could reply the SHO had strolled away, whistling what sounded suspiciously like ‘Love is a many splendoured thing’ under his breath.

  Robert glared after him. So what if he was concerned about Hannah? It was his business to be concerned. She was the newest member of staff, young and inexperienced, and just because he’d never taken an interest in the welfare of a twit like Graeme Jarvis…

  OK, so maybe he was having difficulty forgetting the image of a wet bathrobe clinging to a pair of small erect nipples, but that was only because he was a man, not a monk, and for Elliot to imply…

  It meant nothing, he told himself angrily as he went into the office to see if the blood samples he’d taken for his patient had come back yet. All it meant was that Elliot had a weird and very warped sense of humour.

  Hannah could have done with some of the SHO’s sense of humour w
hen the doors of the treatment room swung open and two paramedics pushed in a trolley carrying a young man who was bloodstained and motionless.

  ‘There’s no need to rush, Doc,’ one of the paramedics declared as she and Jane ran towards him. ‘There’s not a lot you can do for this one. Bullet wound to his head, and with the responses we’re getting on the Glasgow coma scale I’d say he’s had it.’

  ‘Any idea what happened?’ Hannah asked as the paramedics wheeled their trolley into cubicle 3, and she nevertheless began to insert an endotracheal tube, while Jane set up IV lines.

  ‘Your guess is a good as mine,’ the paramedic replied. ‘Where we picked him up, people don’t like to get involved. “Didn’t see nothing, mate”, “Didn’t hear nothing, mate”—you know the kind of place.’

  Hannah did. So many of their patients came from exactly the same sort of area, and at a guess she’d say it was a drug deal gone wrong. Bullet wounds were nearly always a drug deal that had gone wrong.

  ‘Any ID?’ she asked.

  ‘Sam Armstrong, according to the letters in his pocket. We’ll get Reception to check out the address but, like I said, I don’t think there’s any hope for him.’

  Hannah didn’t think there was either. The top half of Sam Armstrong’s head was a crumpled mass of damaged bone and tissue. The ventilator she’d attached him to would keep him breathing, and they could monitor his blood pressure and heart rate, but that was all they could do. With his brain almost certainly irreparably damaged, he was effectively dead.

  ‘Do you want me to page Neurology?’ Jane said.

  Hannah nodded. The neurosurgeon would arrange a CT scan, but from the looks of things it was merely going to be a formality.

  ‘Nice-looking young man, too,’ Jane continued. ‘What a waste.’

  It was an even bigger waste for the kids he’d sold drugs to, Hannah thought bitterly. She’d noticed there were no puncture marks on Sam Armstrong’s arms, or in his groin. He was clearly too smart to take drugs himself. He just peddled them.

  There was nothing else she could do for him, and in truth there was nothing more she wanted to do. All she wanted was to go home and go to bed, and when Elliot hurried towards her to tell her of the case of child abuse waiting in another cubicle, she most definitely wanted to go home.

  ‘Seems the poor kid just walked into the police station, took off his shirt and showed them his back,’ he declared. ‘The police brought him in to us for confirmation of his injuries before they press charges. Look, I’m really sorry about this, Hannah,’ he continued, seeing her expression. ‘I’d take the case myself, but I’ve got a guy bleeding like a stuck pig in 7, Robert’s working on an RTA in 2, and Mr Mackay’s got what looks to be a massive stroke in 5. There’s only you left to deal with it.’

  ‘Is anybody with him? The boy, I mean?’

  ‘I’ve sent Jane in to sit with him. And I’d better warn you—the kid’s in a bit of a mess.’

  A mess was right, Hannah thought as she went into the cubicle and found Jane cradling the child in her arms. He couldn’t have been any more than eight years old and yet every part of his thin, underdeveloped little body was a mass of bruises and scars. Shiny, flat, well-healed scars which must have been inflicted when he’d been about four. Dark red ones which she guessed had been caused last year, and livid, bright red ones which had probably been inflicted as recently as yesterday.

  ‘Why didn’t he go to the police before?’ Hannah said through a throat so tight it hurt.

  ‘He said he could take it,’ Jane replied huskily. ‘It was when his mother started beating his little brother—’

  ‘His mother did this?’ Hannah gasped.

  Jane nodded, her lips grim. ‘Makes you think, doesn’t it?’

  No, it didn’t make her think, Hannah decided as she catalogued every bruise, scar and lesion. It made her want to inflict similar injuries on the boy’s mother, to let her see how it felt to be on the receiving end of such pain.

  ‘What happens now?’ she asked after Jane had gently helped the boy back on with his clothes.

  ‘I should imagine he and his brother will be put into a children’s home until the court case, and then they’ll probably be fostered.’

  ‘I hope they lock his mother up and throw away the key,’ Hannah said grimly. ‘I hope—’ She stopped and frowned, suddenly aware of angry raised voices coming from outside in the treatment room. ‘What on earth’s going on out there?’

  ‘I don’t know,’ Jane replied. ‘But I’ve never heard Mr Mackay quite so angry.’

  Neither had Hannah, and it didn’t take her long to find out why.

  ‘At last!’ the A and E consultant exclaimed the minute he saw her. ‘I want to know what idiot gave Mrs Forsyth a glass of water!’

  ‘Mrs Forsyth?’ she repeated in confusion.

  ‘My slow-bleeding ulcer. Some stupid idiot gave her a glass of water, and now I’m going to have to phone Theatre to cancel surgery!’

  And he would have to cancel. Even something as simple and innocuous as a glass of water could cause vomiting in an anaesthetised patient, with material from the stomach aspirated into the lungs.

  ‘You said her husband brought her in,’ Hannah observed. ‘Could he have given her the water, thinking it wouldn’t matter?’

  ‘He says he didn’t, and I believe him,’ the consultant replied. ‘Which means it must have been one of my staff, and I want to find out who!’

  She could understand his anger—she would have been furious herself—but to her dismay she suddenly noticed Kelly Ross staring at the ground as though she hoped it would open up and swallow her. Oh, no. If Mr Mackay discovered the student nurse was to blame he’d come down on her like a ton of bricks.

  She took a deep breath, and steeled herself for the consultant’s inevitable wrath.

  ‘I’m afraid I can’t help you, sir,’ she murmured. ‘I’ve no idea how this could have happened.’

  ‘It’s your business to know!’ he retaliated. ‘I put you in charge of this patient!’

  ‘I realise that, sir, and I take full responsibility for what has happened,’ she replied, managing to meet the consultant’s blazing eyes, though her stomach was churning. ‘And I can only repeat that I’m sorry, and promise it won’t happen again.’

  ‘A fat lot of use that is!’ he exclaimed. ‘I’m the one who’s going to look as though he’s in charge of a bunch of bloody fools when I phone Theatre and tell them they can’t operate!’ He started away angrily, then swung back, and she waited, all too aware that Jane was studiously avoiding her eye and Elliot looked deeply embarrassed. ‘The neurosurgeon’s just pronounced the guy in 3 clinically dead. His mother’s in the relatives’ waiting room. See if you can do something right for a change by asking her if she’ll agree to some organ donations.’

  Hannah stared after him in dismay. She hated asking relatives for organ donations. Some people reacted so badly—shouting at you, demanding to know what kind of bloodthirsty ghoul you were—and it didn’t matter that Sam Armstrong was a drug dealer. His mother was still going to be devastated when she told her the situation.

  ‘But he’s still alive?’ Mrs Armstrong declared when Hannah had explained how seriously injured her son was. ‘You’re saying he’s been badly hurt, but he’s still alive?’

  ‘Only because of the life-support machine,’ Hannah said gently. ‘Mrs Armstrong—’

  ‘He’s such a good boy, Doctor,’ the woman interrupted. ‘A lot of the kids round our way they’re into drugs, stealing cars, vandalism, but Sammy…’ Mrs Armstrong’s small, plump face lit up with pride. ‘He wants to make something of himself. I says to him, “Sammy, you work hard all day stacking shelves and sweeping floors at the supermarket. Why do you want to go to college at night? You’re young, you should be out enjoying yourself.” And he says, “Ma, I’m going to be somebody. I’m going to get a good job, then we can all live somewhere nice where they don’t have spyholes in the doors, and bars on the wind
ows.”’

  Tears welled in Hannah’s eyes, and she desperately blinked them away. She didn’t want to hear this. It had been easier when she’d thought Sam Armstrong was a drug-dealer, a low-life. She didn’t want to know that he’d been a good son, an ambitious young man and a kind one. ‘Mrs Armstrong—’

  ‘His friend Joe—he told me what happened. He and Sammy, they were on their way home from the night college, you see, and they see this black boy attacking this white kid. Joe, he thinks they should just pass by, not get involved, but Sammy, he says, no, they gotta help. So he drags this black boy off the white kid, and the black boy—he pulls out a gun—’

  ‘Your son was a very brave man, Mrs Armstrong, a very brave man,’ Hannah interrupted, wishing the woman would just stop, wouldn’t tell her any more. ‘That’s why my consultant was wondering whether you might be prepared to—’

  ‘I don’t have much money, Doctor,’ the woman continued, pulling a battered purse out of her handbag, ‘but I want you to take this to help make my Sammy well again.’

  Hannah stared at the purse in dismay. ‘Mrs Armstrong, it isn’t a question of money—’

  ‘I’ve been saving up to help Sammy with his college fees, you see. There’s £200 here, Doctor. I know it’s not a lot, but I clean offices at night and I can get more work, clean more offices—’

  ‘Mrs Armstrong, there’s nothing we can do!’ Hannah said desperately, then bit her lip when the woman flinched. ‘I’m sorry. So very sorry, but all the money in the world isn’t going to make Sammy well again. There’s nothing we can do. I wish there was. I truly, truly wish there was, but there isn’t.’

  For a long moment Mrs Armstrong stared at her, her eyes large, black pools of pain and distress, then slowly she put her purse back into her handbag. ‘I see. I understand. Can I…can I see him, Doctor?’

  Hannah nodded, and gently guided the woman along the corridor to the trauma room. Kelly was there, looking as grim as she herself felt, but she’d done a good job on Mrs Armstrong’s son. There wasn’t a mark on the young man’s face. The only evidence of his horrific injury was the bandage she’d tied tightly round the top of his head.