First,
check everything for the consultant’s round at nine. The mundane: beds tidy, floors clean, equipment cleared away …
The
detail: patients’ notes, graphs, recordings all in order …
The
technical: monitors functioning properly, life support systems, infusion drips …
Patients
happy …
Our
consultant, Mr Chorley, had a gift for making patients happy. He gave each one a portion of his undivided attention. His manner was so reassuring that even the most sick brightened up. And he didn’t bully his house officers either; at least, not in front of the patients.
He
was a small, slight man who always wore a dark suit and was consistently immaculate in appearance — unusual in a small man. He was balding, wrinkled, and his blue eyes were faded. He could so easily have been a figure of fun, but he wasn’t.
‘
Good morning, Mr Ashbourne. How are you feeling today?’
‘
Fine, thank you, Doctor.’
‘
Fine —
all
right
, or fine —
really
fine
?’
A
smile. ‘Fine — all right.’
A
quick look at the charts. ‘Better than you were feeling yesterday, anyway?’
A
vigorous nod.
‘
Chest pain?’
‘
Some. Here.’ He indicated with his fingers.
‘
That’s only to be expected at this stage. Let me look at this chart a moment. Hmm.’ He showed it to the house officers. ‘Any comments?’
‘
A good response to isosorbide. Steady progress.’ Paul Ridware, house officer: shiny black hair, dark complexion, smooth and sensual.
‘
Ye — es. What about this?’ He pointed to a dip in the graph.
‘
Dosage a little too low?’ Deborah Hillard, senior house officer: slim and assured, attractive, with curly auburn hair.
‘
What would you recommend?’
‘
Increase by five milligrams daily?’
‘
Yes. I’d agree with that.’ He turned to Stephen. ‘Can you organize that, please, Dr Wall?’
‘
Certainly, Mr Chorley.’ He made a note.
Back
to the patient. ‘You’re doing well, Mr Ashbourne. We’ll be transferring you to the Coronary Care ward soon. Tomorrow, or perhaps the day after. We’ll see.’
‘
Thank you, Doctor. I — er — thanks.’
‘
You’re very welcome.’
Move
on to next patient.
Including
the beds in the isolation rooms, our ITU held only nine patients, so the ward round didn’t take too long.
And,
pleasant man though Mr Chorley was, we all heaved a metaphorical sigh of relief when he’d moved on to the next ward.
Then,
to work.
Organize
changes in drug therapy. Take a patient off the monitors. Arrange for collection of blood samples.
Minor
medication to relieve minor aches and pains, sore arms from infusions and venepunctures …
Mrs
Peters rang, tearfully asking for Mr Peters’s wedding ring which hadn’t been with his other effects. I assured her it would be returned, thinking,
Oh
my
God
, not a thief on top of everything else,
please
…
Jenny
Towers, the physiotherapist, arrived with a list of patients to see …
The
ECG technician, Jacqui (with an i) Newborough, brought in her equipment, picked up her requests and started work …
Pat
Drayton, phlebotomist (a fancy title for blood sample taker) picked up
her
requests and studied them for a moment.
‘
Susan not around?’ James asked her.
‘
She’s off for a fortnight,’ replied Pat. ‘Why? Aren’t I good enough for you?’ Put as a joke, but defensive all the same.
‘’
Course you are, Pat. Beautiful, too. Just wondered, that’s all.’
In
fact, Susan King, our usual phlebotomist, was much better than Pat, who tended to be rather brutal when she couldn’t find a vein first time.
‘
Pat ...’ Gail Colton, staff nurse, said. ‘Try Mrs Weston’s right arm today, would you? Her left’s in a bit of a mess.’
‘
OK,’ said Pat. ‘But she’s got terrible veins, that one. Really difficult to find.’
‘
All right, Pat. Just do your best. I’ll be glad when Susan’s back,’ she continued in an undertone when Pat had gone, and we all agreed. Dumpy, unobtrusive Susan who quietly got on with the job; so gentle that several patients had said they literally couldn’t feel a thing when she pushed her needle in …
‘
Jo,’ said Gail, ‘that deadbolt on the air-lock is sticking again …’
I
went out with her to have a look.
‘
OK, I’ll phone the engineer …’
Emma
Riley approached me. ‘Can I have a word please, Jo?’
‘
Sure. Let’s go in here.’
We
went into the empty rest room.
‘
Could I swap patients with James, please?’ She was very red in the face, I noticed.
‘
What’s the problem?’
‘
Mr Phillips, he’s just too much. I know I’m a big girl now, but this morning, while I was adjusting his electrodes, he managed to feel my thigh with his right hand and stroke my breast with his left at the same time.’
She
was really upset, I noticed.
‘
No problem. D’you want me to have a word with him?’ She shook her head. ‘No, there’s no point. He’s not going to make it, is he?’
‘
No,’ I agreed …
How
strange, I thought. Emma, with her honey-coloured hair, honeypot face and body (I’d seen Stephen and Paul and James all drooling over her) so prim and proper — a churchgoer, I’d heard … and Mary, who looked so coolly beautiful, yet who could be truly wanton …
They
were both good nurses, though — parts of the team I wouldn’t have wanted to be without.
The
door opened and James came in.
‘
Sorry, am I interrupting something?’
‘
No, we’d finished,’ I said. ‘In fact, it concerns you, James.’
‘
Oh?’
‘
Why don’t you make us both a coffee while I tell you?’
‘
Sure.’
A
wry smile touched his pale, pleasant face, with its slightly flattened features, as I explained why I wanted him to change patients with Emma.
‘
I’m not surprised,’ he said. ‘I saw him ogling you yesterday, Emma. Funny, isn’t it,’ he continued. ‘How it’s sometimes the most ill who are the randiest. As though they’re making up for lost time.’
‘
Thank you, James,’ I said, ‘for that penetrating insight. Now how about that coffee?’
‘
Oh, right.’
I
’d barely finished drinking mine when Miss Whittington’s head appeared round the door.
‘
Sister Farewell, could I have a word, please?’
‘
Of course.’ I put the cup down and went with her to my office.
‘
Your report on Mr Peters covered everything satisfactorily. I don’t think we need take the matter any further.’
‘
Oh, good. Thank you.’
‘
Have you spoken to Sister Tamworth?’
‘
Yes, I have. She accepts the criticism; in fact, she offered to apologize to you personally.’
‘
That won’t be necessary.’
‘
That’s what I told her.’
‘
Good.’ She hesitated. ‘And have you had time to reflect on the other matter?’
‘
Er — yes, I have.’ Her look told me that more was required. ‘I — er — I’ll wait and see whether there are any more unexpected deaths, as you suggested.’
‘
Good. I’m quite sure you’ll find that there won’t be, and that things will even themselves out.’ She paused. ‘I notice you haven’t taken any leave for some time. Perhaps you need a short break. Are many of your staff away at the moment?’
‘
Yes, several, including one of the sisters, Vivien Aldridge.’
‘
Ah, yes. When is she due back?’
‘
She’s off for two weeks, so today fortnight.’
‘
Well, perhaps you could take some time off when she returns.’
‘
I’ll bear that in mind,’ I said.
‘
Good,’ she said for a third time, and made for the door. ‘Oh. Have you drawn the attention of your staff to Mr Chorley’s talk tonight?’
Had
I?
‘
I’ll make sure I remind them, Miss Whittington.’
Damn!
I thought as she left. I’d have to go myself and drag some of the others with me.
Mr
Chorley gave a talk every two months on the care of cardiac patients — he had responsibility for the Coronary Care and Medical wards as well as ITU. He was an excellent speaker and it was to his credit that he gave of his time for the benefit of new staff, but when you’d heard it three times already, as I had, the prospect wasn’t quite so alluring.
I managed to bully half a dozen or so of the others into attending, and by seven was back at the hospital myself and on my way to the lecture theatre when I ran into Stephen. ‘Still here, Jo?’
I
explained about the talk and how I felt obliged to go myself, when so few of the others could.
‘
I’ll come with you, then,’ he said.
‘
Surely you’ve been to one of his talks before? Not that I mind you coming,’ I added quickly.
We
resumed walking.
‘
I did go to one when I first came here’ — Stephen had only been at the hospital for a few months — ‘but I was called out halfway through. Never seemed to have found the time since.’
We
arrived and he held the door open for me.
The
small lecture theatre was fairly well filled and we chose seats at the back — instinctively, perhaps. I could see Student Nurse Pete Hadley (Armitage was still off sick) nearer the front with two or three of the others.
The
talk was opened by Dr John Cannock, St Chad’s director of Pathology, who was chairman of the lecture group that year.
‘
It gives me very great pleasure,’ he said in warm, rounded tones that issued from his large frame as though it were a sound box, ‘to introduce my colleague, and friend, Richard Chorley …’
‘
That’s rich, coming from him,’ Stephen murmured. ‘I’d have thought he’d have ducked out of this one.’
It
was no secret that Mr Chorley and Dr Cannock had fallen out over the provision of laboratory testing in ITU and disliked each other intensely.
‘
He appreciates the irony, perhaps,’ I whispered back.
Mr
Chorley’s talk itself lasted for about an hour, after which, Dr Cannock invited questions. It was while Paul Ridware was asking a particularly tedious one that Stephen touched my shoulder and breathed in my ear, ‘Share a bottle with me in Luigi’s?’
I
smiled and nodded and we slipped out.
‘
My car’s in the staff park,’ I said when we were in the corridor.
‘
It’s a nice evening,’ he said. ‘Why don’t we walk?’
‘
Why not indeed?’
Although
by now it was dark, a band of light lingered in the west, and that, and the soft warm breeze made it good to be in the open air.
‘
I’m rather glad I went now,’ I said, after we’d walked a little way. ‘He …’ I searched for the right words … ‘He has a gift for making you feel useful, reasserting your faith in your job.’
‘
Perhaps he missed his vocation,’ Stephen said lightly. ‘Perhaps he should have been a cleric.’
‘
Oh, that would have been a waste.’
‘
Joking.’ He held my arm as we crossed the road. ‘So the Witless elicits in you the same fear she does in me,’ he said when we reached the other side.
‘
How d’you mean?’