by Sonia Henry
We all nod our understanding. I remember Tom the anaesthetics registrar from our house party and his little bag of cocaine and tell the Godfather he’ll be in good company.
Sometimes you meet someone and know straight away they’ll become your friend. Call it serendipity, or fate, or bad luck that we’re all stuck in Wingabby together, but the Godfather slots into place as the final member of our doctor quartet like the winning token in a game of Connect Four.
Despite, or maybe because of, his less-than-legal extracurricular sources of income, I like the Godfather. He tells us he was a lawyer before becoming a doctor and we’re all suitably impressed. He’s good-looking and deceptively quiet, which we soon learn has afforded him much success with the hospital nursing staff.
‘There’s gotta be some nurses out here,’ he says hopefully. ‘Every hospital has at least two decent-looking nurses.’
‘You might want to pace yourself,’ Estelle advises. ‘We’re here for over eight weeks, so that’s an average of two a month, if you stretch things out.’
The Godfather and Max have been placed in the old fibro shack next door to ours, and are similarly dismayed.
‘These places aren’t exactly hot-nurse magnets,’ the Godfather says, looking demoralised as he gazes at the brown decor. ‘We want a love shack, not an actual shack.’
‘It looks like it’s been painted with shit,’ Estelle says, not bothering with niceties.
Max laughs gleefully. ‘The princes of Poo Palace!’
‘Or fifty shades of shit.’ Estelle grins despite herself.
The Godfather passes me his spliff, and I relent and take a long drag. I pass it to Estelle, who passes it to Max, and soon we’re giggling like schoolchildren on the brown couch, staring at the brown walls which match the brown ceiling and brown floor.
Estelle turns on the ancient brown radio, which only seems to pick up one station.
‘Classic hits on a steamy Wingabby weekend!’ the broad Australian accent tells us enthusiastically as the music starts to play. ‘Hope you’ve all got your fans on!’
As the haze of marijuana smoke floats above us, the radio blasts out classic hit after classic hit. Max is arguing with the Godfather about the best surgical program to apply for, Estelle has taken a valium and her eyes are as hazy as the room, and I sink into the brown couch, watching the words of the classic hits of Wingabby walk through the air in front of me.
Dr Katarina Holliday—this is YOUR life.
seventeen
The days, we soon realise, are long and hot out in rural New South Wales. We wake up in the heat, go to work in the heat, walk home in the heat, then go to the pub to try to drink ourselves away from the heat. I’m too scared to swim in the river in case I encounter a snake; I don’t trust that anyone in the local hospital is competent enough to save me in the case of a fatal bite.
Wingabby Base Hospital has the dubious honour of being named worst hospital in the country a few years running. (I’m not exactly sure where the data comes from for this study, but I believe it.) For some reason the electricity is faulty, and I don’t believe for a second the hospital’s claims it can’t be fixed. This means that the heating is left on even on thirty-plus-degree days, because it can’t be switched off. The hospital might as well have a big sign out the front saying, WELCOME TO DANTE’S INFERNO.
‘All the doctors from Sydney do is complain,’ says Maureen, a thin blonde with a taste in fashion surprisingly similar to Nicole’s, when we meet for our rural induction at the end of the week. ‘The last group were absolutely impossible.’
Despite the obvious shortcomings of Sydney doctors, Maureen has enough kindness in her heart to cease the berating and instead offer everyone a homegrown orange. ‘Wingabby has the best oranges in New South Wales,’ she tells us proudly.
We dutifully eat our oranges, which to my surprise taste incredible.
‘Medical admin don’t give us homegrown oranges in Sydney,’ Estelle whispers to me. ‘Quite nice of her, really.’
I’m so used to steel scalpels and synthetic antibiotics and plastic cannulas I’d forgotten there’s magic in the world not performed in an operating theatre or created in a pathology lab.
My phone pings. It’s a message from the Godfather, who’s sitting on the other side of the room.
Wonder what else Maureen grows on her farm, with a winky emoji.
I show it to Estelle.
‘It’d be hydroponic for sure,’ she says. ‘Everything’s so natural and clean out here, man.’
‘And we have our country races coming up this weekend,’ Maureen says, looking excited. ‘It’s the biggest event of the year!’
Estelle smiles. ‘Who knows, mate,’ she whispers, nudging me, ‘might find me a farmer!’
As we file out of the room and into the sweltering heat of the ward, I say, ‘It hasn’t been all bad out here so far. I mean, imagine if we’d never met the Godfather!’
‘The guy is a genius,’ Estelle agrees as we struggle up the stairs. ‘Yesterday he corrected the consultant nephrologist because he’d got the patient’s creatinine clearance wrong. Like, he figured it out in two seconds. Without the calculator.’
The Godfather, it turns out, is a regular Stephen Hawking, which is handy in a place like this, where the computers crash regularly, and also because I often need his help. Wingabby is my medical term, unfortunately for me. Being more interested in surgery means I find the long ward rounds and physician-like discussions more tedious and confusing than ever. There’s no operating theatre with Dr Prince to pop into to break up the day a bit, just neverending discussions about Mr Larson in bed 9’s worsening renal failure.
I arrive on the ward and ring Dr Woo, my consultant, to tell him our sickest patient, Mrs Richards in bed 4, has a high fever and her blood pressure is dropping. The consultants are all fly-in fly-out from a variety of other, bigger hospitals, and when it’s time for the fly-out part of their contract their plane waits for no man, meaning they wait for no patient or junior doctor. Dr Woo is already at the airport, even though it’s only midday.
‘Call the registrar,’ he tells me. I can hear flights being announced in the background. ‘I’ll be back on Thursday.’
I’ve only met the registrar briefly. She’s so busy we usually only have time for a cursory discussion about the patient list first thing in the morning then we go our separate ways. We have so many patients it’s nearly impossible to keep track.
I call her anyway. ‘I think Mrs Richards is septic.’
‘Who?’
‘Urosepsis, seventy-two, has a glass eye,’ I remind her.
‘Does she have an advanced care directive?’
‘I don’t think so,’ I reply.
‘She’s not for resuscitation though, is she?’
‘I don’t think that’s right,’ I say. ‘I heard her saying to the nurse the other day that she wants to be resuscitated if she has a heart attack.’
‘Has she said that to you directly?’ She sounds irritated.
‘Well, no,’ I admit, ‘but she’s delirious now, probably because of the urosepsis, so she wouldn’t be able to tell me even if she wanted to.’
A sigh of relief pours down the phone. ‘Okay, palliate her.’
‘What?’
‘That’s what Dr Woo told me last week,’ my registrar says. ‘She’s got an NFR, she’s suffering, it’s time. Call the palliative care nurse.’
‘But she’s got a treatable infection,’ I point out. ‘We charted the right antibiotic this morning, the nurse just hasn’t given it yet.’
‘What? Okay, stop the antibiotic. Chart the palliative care meds.’
I want to argue but I’m met with a dial tone. I go and take a look at Mrs Richards, who is curled up in the foetal position and letting out an occasional tortured groan.
‘I’ve called the palliative care team,’ the nurse informs me.
‘Really?’ I’m surprised at how efficient she is. Normally nurses force junior do
ctors to do everything, even tasks they can easily do themselves.
‘Dr Woo called the ward.’
I’m impressed that Dr Woo has somehow managed to get in one last palliation before take-off. But I can’t shake the uneasy feeling that something not quite right is happening.
The Godfather confirms my instincts. I’m charting the palliative care crisis medications and actively stopping Mrs Richards’s lifesaving antibiotics when he appears beside me.
‘Do you feel like they palliate a lot of patients in this hospital?’ I ask, worried that I’m just being paranoid.
‘Of course,’ he says, hovering over the medication chart. He takes a pen from his pocket to increase the morphine dose I’ve just written up. ‘They need the beds.’
‘No!’ I drop my own pen. ‘They can’t do that! We can’t kill off old patients when they get a little bit sick just to free up bed space!’
He raises his eyebrows. ‘How many times have you been to the morgue this week?’ He hands me the penny and it drops, like a ton of lead into a bath.
‘My God!’ I am shaking my head. ‘Mate.’
‘Look, they’re all old and suffering anyway,’ he says reasonably. ‘Maybe it’s for the best. In the city we keep people alive for so long it’s cruel, if you ask me.’
Right on cue, my pager goes off. It’s the nurse manager. Another of our patients has died, and I have to go to the morgue to certify the death and do the paperwork.
I finish charting the medications that will free up Mrs Richards’s bed and think about what the Godfather said. He’s right; I seem to be going to the morgue to certify deaths surprisingly often.
The whole act of certifying a death is a little weird. I mean, everyone knows when a person is dead. But for the sake of making sure that nobody (or bodies) slip through the cracks, I guess it isn’t a bad policy to have a doctor make sure.
This little exercise involves me popping into the fridge, where, using a key I’ve been given by hospital security, I unlock the drawer and pull out the body. This can be dangerous: if I pull on it too enthusiastically, there’s a risk the drawer will tip down and the body will roll out on top of me. This happened to another junior doctor the year before, the security guard has warned me.
Once the body is exposed, you have to listen to the heart, the lungs, look at the eyes and try to elicit pain. Nothing happens, of course, since the person is dead. I feel like a total weirdo as I go through the motions. The most awkward part of the whole procedure is feeling the chest for a pacemaker. This is important, because if a pacemaker remains in the body when it’s being cremated, it’ll explode. Still, there’s something totally off about feeling a cold corpse’s chest.
I arrive at the morgue, to find one of the nurses looking flustered.
‘Katarina, we’ve had three triage sixes arrive. The emergency department would normally deal with it but they’re too busy. Can you sort it out, please?’
I stare blankly at her. Triage 6?
‘You know,’ she says, rolling her eyes at my ignorance, ‘DOA.’
DOA?
‘Dead on arrival,’ the morgue attendant explains helpfully as he walks past.
This leads to my introduction to what I like to refer to as ‘the death van’. The death van is a non-descript white van driven by anonymous contractors no one seems to know anything about, who drive around New South Wales fetching dead bodies that need their deaths certified by a doctor.
The van rolls up outside the hospital; the contractors tell the staff they need a doctor to certify a triage 6—or dead on arrival—then they wheel the body back into the van and disappear mysteriously, as if they were never there.
I stare at the van doors, almost morbidly fascinated, wondering what is about to declare itself. The death van driver then helpfully explains. ‘And sorry, Doc, but one of them’s a decomp.’
I’m getting sick of all these abbreviations. ‘Sorry?’
‘Decomposing. You know … smell’s not great.’
Holding my breath, I watch with voyeuristic horror as they wheel out the ‘decomp’ and unzip the blue body bag. I stare at the withered, blackened corpse in front of me. ‘Looks pretty dead to me,’ I say, holding my nose. ‘Do you reckon I need to do everything? Like do I really need to check his pupils and stuff?’
I wonder whether I should go through the proper motions and listen to the corpse’s chest to ascertain there are no breath sounds or heartbeat, but I start to feel a little queasy at the thought of my stethoscope touching a dead body, which has been decomposing for the last month. I settle for putting on some gloves and palpating the chest for any movement, which is horrible enough.
‘Yep, dead … definitely dead,’ I say firmly, signing off on the clipboard.
‘Okay, there are two more to go, Doc.’
‘All right, wheel them out,’ I say, trying to breathe normally now the ‘decomp’ is safely back in his zipped bag on the van shelf.
I look down at the face of an elderly lady and feel a twinge of sadness. She’s been found by a neighbour, dead on her lounge. This is how it all ends. With me, an ineffectual junior doctor, standing outside the hospital morgue while I check her off as ‘dead’.
Death is an abstract concept, even for doctors. It’s not until I find myself standing there, staring down at the dead face of a woman I’ve never met and who no one will ever meet again, that I stop to think for a moment—this is life, playing out in front of me. The end of a life. The enormity of the concept hits me, hard, and then it’s gone.
‘Some doctors yell out their name,’ the death van driver says helpfully.
‘EVELYN!’ I yell at the corpse, wondering why I’m trying to elicit a response from somebody who’s clearly not going to respond.
‘I think her friends called her Evvy,’ the death van driver offers.
I look at him. ‘EV—’ Halfway through yelling out her nickname I realise how ridiculous this is. Evelyn isn’t going to suddenly wake up and say hello just because I use her nickname. Evelyn—nickname Evvy—is dead as a doornail and it doesn’t matter how many anecdotal forms of address I use, Evvy isn’t coming back.
I listen to Evvy’s chest—no breathing sounds. I listen for her heart—no heartbeat. I shine a light in her pupils—fixed and dilated. ‘Ah, yep, dead too,’ I say, awkwardly, signing the form.
The contractors who drive the death van pack up their grisly cargo and vanish off into the steaming Wingabby summer afternoon. Out of habit, I quickly cross myself. I sort of hope even as a person of science that the dead have a safe passage somewhere into their next journey. I wish for a moment we were like the ancient Greeks, where every dead person had a gold coin placed on their forehead, to give to the boatman to take them across the river and away from Hades, but there are no gold coins and no boatman waiting. Just the death van, a steel slab, and a half-unzipped body bag.
I remember, out of nowhere, one of Mum’s more fatalistic quotes, a biblical reference that she liked to toss around when I bemoaned the misery of studying and life generally.
Remember man that thou art dust, and to dust thou shalt return.
‘There was this one time when the doc certified the wrong body.’ The morgue attendant is back, hovering next to me.
I jump up, out of my thoughts. ‘What?’
He laughs, coffee-stained teeth flashing at me. ‘Yeah, it was a doc like you, from the city. He certified a death and signed the back of the form then, after the van was long gone, he checked the name and realised it was an old Italian bloke, when the death he’d certified was a sheila in her early forties.’
‘What?’ I feel horrified. ‘But couldn’t he just ring the … you know … van drivers?’
‘Well, that’s the thing,’ the morgue attendant grins ghoulishly. ‘No one really knows who they are. They’re just contractors, you see.’
Fantastic. ‘So what happened?’
‘Ah, it turned out all right. He called the police and crosschecked with them and found
the body but, you know, it was a scare.’
‘Hmm.’ I feel disconcerted, to say the least. I imagine the death van drivers running some kind of organ-pilfering ring, which hapless junior doctors become accidentally party to. There’s a good horror movie in that for sure.
This proximity to death has me standing on the edge of a full-blown existential crisis, I realise, as I wait outside the morgue for my friends to walk home, in my mind halfway through the screenplay for Death Van: Part 3. I feel an intense longing for the shallow days of binge drinking, arguing with Winnie about putting out the bins, and my pathetically huge crush on my surgical boss.
Max arrives first, looking pleased with himself. The only other gay man in the hospital, a nurse called Robert, has invited Max to the Wingabby races this weekend.
‘I’ve heard the country races are pretty fun,’ I tell him, having listened to the nurses on my ward gossiping about them. ‘Maureen looked super excited when she told us about the races at orientation. I think it’s like the biggest event of the year.’
Max looks pleased. ‘It’ll be a good story, don’t you reckon? That time I went to the country races when I was a junior doctor in a town of seven thousand people.’
Like me, Max sees the value of a good story. Even the biggest catastrophe can be turned around a few months later over some wines and a good laugh. Not that one ever wishes for a catastrophe, I remind myself, thinking about my colleague and his lost body, shuddering. I’ve had enough to do with the death van for one lifetime.
eighteen
On Saturday I sit on the couch in poo palace considering Max’s chosen outfit for rural race day. ‘The light blue is better than the pink,’ I decide. ‘And I like your R.M. Williams.’
Estelle is still asleep, even though it’s after midday. She ‘treated herself’ to a heavy dose of wine and sedation last night and will be in bed till at least 4 pm.
‘Are you sure you don’t want to come?’ Max says.
