Authors: Elizabeth Buchan
He wasn’t sure if his father had ever forgiven him for that.
The clamour in Jake’s head faded. He fell back into sleep and found himself labouring on a vast bookcase, which demanded ever-more precise measurements and a plenitude of finials, architraves and recessed beading.
Then he woke up again. Dozed. Woke.
Sewn into the wake-sleep periods, the apparitions came and went.
In the early hours, he woke properly. Maisie was crying. Head buzzing, mouth dry, he fumbled out of bed and tried to remember if he had decanted water into her bottle.
He hadn’t, and her cries intensified as he fumbled around the kitchen and climbed back upstairs. A drenched pair of cornflower blue eyes accosted him as he lifted her on to his knee. ‘You really shouldn’t need a drink in the night.’
The sobs abated. Maisie relaxed against him. One arm banged the bottle, the other was tucked peacefully against Jake’s torso.
While she drank, Jake considered the vows he had taken during his life.
I take you to be my wedded wife –
that was null and void. The other was to protect Maisie and to give her the chance of a good life. He remembered the night she was born, its white-gold dawn aftermath and the accompanying aftertaste in his mouth of flat champagne and bad hospital coffee. He had been changed, utterly changed.
Save for Maisie’s snuffles, the silence was crushing.
When she had finished, he sat her up and rubbed her
back. Already he was beginning to understand her body language better – and satisfaction trickled through him.
He waited for a rude and gusty spasm of air to be released through her rosebud mouth before lifting her into the cot and tiptoeing away.
Downstairs, he poured himself a slug of whisky, which did dreadful things to his head and stomach, and eyed the phone. Eventually he put a hand around the receiver. It was cold – not as cold as stone but as cold as plastic material in an unheated house. He dialled.
‘Jocasta …’
‘Jake?’ She was startled.
‘The man you married. The very one. Having trouble remembering?’
‘What do you want?’
‘You have to come back. You can’t walk out on us.’
‘You’re drunk.’
‘Possibly.’
‘Listen, Jake. We’ve been through this –’
‘You’ve been through this,’ he interrupted. ‘Not me.’
‘
I
’ve been through this. It’s decided. I’ve gone away because what we had didn’t suit me, and I would have made you and Maisie unhappy. What can I do to make you believe me?’
Hope finally died. He had loved Jocasta – oh, he had loved her – and he had believed that his love would be sufficient for them both. But it hadn’t been, and it wasn’t.
In those final moments before hatred and disgust took over (which Jake knew they surely would) he bade goodbye to that love.
He put down the phone. Now it was post-Jocasta. Post-marriage. Post … what?
Chapter Ten
One of the consequences of Tom losing his job was to make Annie view hers in a different light. And it wasn’t just the spectacle of an unshaven Tom looking up from the breakfast table and saying brightly and heroically, ‘Have a good day.’ It was a shift from regarding a good job with sufficient intrinsic interest and remuneration as a guarantee to self-respect – almost a luxury – to a position where the anxieties of being the sole breadwinner had never been so acute.
Annie’s mother had loved a good cliché and had plenty of them for most occasions. ‘Don’t knock ’em, Annie.’ She had been chopping carrots like the Demon Barber at the time. ‘They’re a fall-back when the going gets tough …’ Coming to terms with the new situation, Annie found herself –
thanks, Mum
– repeating to herself,
A change is as good as a rest
. In the circumstances, it was useful as she grappled with Tom’s new situation. And what about her own? If she had ever felt dissatisfied with parts of her work, the loneliness of being the family’s sole breadwinner swiftly ironed out any pockets of resistance.
What would happen if she lost
her
job?
Electrifying patients and staff in a pair of red high heels with lipstick to match, Sadie swept down to St Brigid’s and took her out for a backbone-stiffening lunch. Annie found herself airing these fears.
Sadie looked astonished. ‘Sakes, you can always find
another one.’ She reached over the table and patted Annie’s hand. ‘You Brits don’t understand about get-up-and-go.’
‘Fine. So the
Mayflower
didn’t sail from these shores and we didn’t have an … admittedly embarrassing … empire on which the sun never set?’
‘Well, here’s the thing.’ Sadie twinkled sardonically over her spelt and pumpkin salad. ‘All you did was to create Little England in the jungle. That’s not the same thing as thinking out of the box.’
‘Remind me, Sadie, why are we friends?’
‘Because.’ Sadie grew serious. ‘Annie, how is Tom?’
‘Going for job interviews and coming home looking like death. It’s really tough. The economy and all that.’ She entertained an all-too-vivid picture of Tom aimlessly wandering around the house. ‘I feel agonized for him. He’s been cut off at the knees.’
‘For God’s sake, Annie. Are you ill? No. Are you alive and well? Yes. Have you a roof over your head? Yes. What’s there to be cut off at the knees about?’ She added, ‘Send him over to me. OK?’
‘Never. You’re an official man-eater.’
Like Cleopatra’s, Sadie’s smile reflected infinite variety and wisdom. ‘Just because I’ve had three husbands doesn’t mean I want yours. I love my Andrew.’ She poured out the last of the wine. ‘Drink up, this is on me.’ She peered at Annie. ‘Do I detect an expression that suggests I’d be welcome to Tom?’
Annie grinned. ‘That’s quite another topic.’
The Middleton Wing was the hospital’s administration block where the meeting had assembled to discuss the case of Samuel Smith who had died earlier in February in A and
E. (Tom had been right that it would cause trouble.) The company included two consultants, union representatives, a lawyer, plus the usual suspects from Annie’s department and the press officer.
Her boss, Charles Thompsett, got to his feet. Ten years younger than Annie, he was fast-tracking up the NHS bureaucracy, liked to be known as Chuck, and cultivated an impatience that was sometimes justified. ‘Ladies and gentlemen …’ He was as oily smooth as only a fast-tracker could bring themselves to be. ‘I’m sure you’re all aware that Samuel Smith’s parents are suing the hospital for negligence.’ He glanced around the faces at the table. ‘This is a most unfortunate case. Of course, our thoughts are with Mr Smith’s family but …’ he barely checked himself ‘… but apart from anything else the press are on to it. I’ve already talked to a couple of editors and they tell me they think there are grounds for representing it as gross negligence in a failing hospital.’
There was a sharp collective intake of breath.
Chuck consulted his notes. ‘You all have a copy of the internal report. Please turn to page one.’
Samuel Smith had arrived in A and E at 1.32 p.m. in considerable distress from abdominal pain. There had also been a major traffic incident with multiple injured and, as a result, he had not been triaged for half an hour.
This last fact alone was troubling. If it had been one of my children, thought Annie, I would be shouting it from the rooftops.
At 2 p.m. Samuel Smith had been heard to call out from the gurney where he had been placed in the corridor. No one was free to respond.
Annie could not bear to think of how Samuel Smith must have felt as he lay dying on that unforgiving gurney.
There were murmurs and rustles in the warm, coffee-scented room. One of the consultants got up, poured himself a cup and helped himself to a Jammie Dodger and a custard cream from the plate.
At 2.30 p.m. Samuel Smith was heard to call out a second time. Again, no one was available to respond.
Chuck looked up from the notes. He was grim. ‘Did anyone have contact with Samuel Smith at this point?’
Annie did not need to check her reports – much of what they said was burned into her memory. ‘No. But Nurse Flynn heard him calling out for his mother.’
The press officer coughed and the lawyer wrote a note at high speed.
‘You should all note that timings concerning Samuel Smith’s admission fell within the target times. This is important and forms part of the defence,’ said Chuck.
Annie glanced around. The consultants exchanged a look and one union representative wore a belligerent expression. The majority at the table would be thinking the same thought: target times are irrelevant if you’re dying and requiring help. No one, including herself, was going to spell it out.
‘… absolutely sure of the facts before …’ Chuck was saying. He continued in this vein for a while longer and finished, ‘I’m going to hand over to Annie Nicholson.’
She was used to this. Even so, her heartbeat quickened. ‘You will all have been briefed on this case. The timetable is likely to be this …’ She outlined the legal and administrative procedures and indicated how they would affect the parties present around the table. She ended, ‘No one is to
discuss this case outside the proper channels and certainly not with the media.’
When she sat down, Chuck raised an eyebrow a millimetre. You did fine, it said. ‘Questions?’ he asked. He took care not to focus on anyone in particular.
The biscuit-eating consultant raised a hand. A crumb of custard cream clung to his cuff and he brushed it away fastidiously. ‘As the representative of A and E, I will be reviewing the procedures but I’m convinced that doctors are not to blame.’ He paused. ‘This unfortunate death is the result of too many targets and too much paperwork, which we have talked about many times. In my view, it could have been avoided.’
One of the union representatives, smart, dapper and razor-sharp, cut in: ‘We would like to make clear that we feel strongly that our nurses are not accountable. If there is blame to be apportioned, and there will be, we would insist that a close look is taken at managerial practices.’
The medics at the table had retreated into their bunker. In a long, trying war, hostilities had again opened up between them, the managers and administrators. Into the gap between the opposing factions, thought Annie, despairingly, would fall Samuel Smith and his too-brief life. What are we missing that we cannot work together? she wanted to demand. Why do the sick get sidelined? Why do we, the managers, get it wrong?
‘We must be careful,’ she closed proceedings, ‘not to indulge in internal disputes. This case is, first of all, about whether we failed a patient or not, and second about the hospital and its reputation.’
Afterwards, Annie found herself peering at herself in the
female washroom. The mirrors needed cleaning and she appeared blurred around the edges. Snatching up a tissue, she leaned forward and rubbed away until her image emerged sharper and clearer. Battle was for the young – only they could stand its physical ordeals and psychological terrors – and going into battle also depended on a degree of coercion.
Samuel Smith had been only thirty-two. Not so very much older than her own children. That made her think of Tom, whom she had left stuffing clothes into the washing-machine, and her mood darkened.
She tucked back an unruly lock of hair and regarded the result.
‘Are you all right?’ Sarah, her assistant and friend, poked her head around the door and broke into her reverie.
Annie whipped around. ‘Fine. Just hating the hair.’
Sarah looked a tad sceptical. ‘And …’
Annie regarded the curls that, over the years, had given her so much grief. ‘Only good when I’m pregnant … How sad is that?’
… Arriving back from hospital, bearing the tight-wrapped forms of the twins, her hair manageable and glossy from pregnancy hormones, skin glowing with post-partum exhilaration. Tom ushering her up into the bedroom and her gasping on the threshold for he had filled it with roses – dusty pink, pearly white, beige – and the double bed made up with clean sheets. It had been a room scented with flowers, with excitement – and with love …
Sarah said, ‘When you’re done having the bad-hair moment you’re wanted by Him.’
When the twentieth-century architect had tacked Middleton Wing on to the main Victorian building, he had
abandoned the notion of putting in windows that opened, and during warmer weather, the stuffy atmosphere often made her feel light-headed. The Admin offices honeycombed a corridor along which patients were wheeled on the way down to Theatre Five. Occasionally, and guiltily, Annie glanced up from her desk to witness a nurse’s struggles to manoeuvre a patient, but an unwritten rule kept Admin behind their doors.
Chuck had the largest office at the end of the corridor. Jabbing a finger at a chair, he indicated that Annie should be seated while he finished a call. But the call couldn’t be finished quickly and Annie BlackBerryed a message to Sarah. Surgeons refusing to use cheaper gloves ordered by Procurement. Message is: don’t care how f***ing expensive Biogel gloves are, and what savings the cheaper brands will make, that’s what they want. Also say that if Admin can’t get their fat heads around their needs then they should go home. You to sort?
Actually, it wasn’t
so
funny. Procurement should know better than to allow trenches to be dug. Sorting out the rubber-glove skirmish meant hours of extra negotiation, plus the upshot was not in any doubt. The surgeons would get their Biogel gloves – bought specifically for their use.
Chuck put down the phone. ‘Well done, Annie. We’ve made a start.’
She pushed a curl behind her ear. ‘There’s a meeting with the lawyers next week. It’s been put into your diary.’
‘There’s one other thing.’
She anticipated what it was likely to be – which wasn’t difficult. Chuck’s ambitions dictated his actions but, to be fair to him, his ambitions were not exclusively directed to
his own advancement. He was genuine about wishing the hospital to be a good one. They all were.
‘Superbugs?’
‘Got it. We’ve had a tip-off that the DoH is about to issue new guidelines. They’ll be sending in the superbug squad and it would be good if they found we had it in hand.’