Nurses: Claire and Jan

by Bette Paul

  “Jan! You running?” It was Karen. “Jan? Come on! Twice round the spinney, last one home’s a dwork.”

  A what? thought Jan, automatically reaching out for his notebook. But his hand dropped even before it reached his locker; it didn’t matter now. He pulled the quilt up over his face and lay quite still, waiting for the footsteps to continue.

  When they did, he sat up, pulled back the curtains and looked out at the grey drizzle. Tears fell unheeded down his cheeks, off his chin, though he couldn’t think why they should; he wasn’t consciously weeping, wasn’t even unhappy. Wasn’t anything. He slid back on his pillows and slept.

  Again the knocking awoke him, but this time it was different – firmer, sharper. The door opened and Geoff came in.

  “You missed the run this morning, Jan,” he announced, ignoring the inert figure in bed. “Still, you’ve just got time for a bit of breakfast, then I’ll see you in my office at nine. Right?”

  Shocked into action, Jan sat upright, wide-eyed. “I can’t,” he said.

  “What do you mean?” asked Geoff sharply.

  “I can’t do those things – go to breakfast, to your office.”

  “Why not?” Geoff looked genuinely surprised. “You’ll make it in time if you get a move on.”

  “No, I don’t mean there’s no time. I mean I can’t . . . can’t . . .” Jan’s voice trailed miserably off.

  “Can’t what?” Geoff asked, gently persisting.

  Jan gave a shuddering sigh. “I can’t get up,” he muttered.

  “I see.” Geoff looked at him thoughtfully. “Well, your injuries were quite slight – that cut on your arm, a few bruises. Maybe it was the bump on your head. Shall I send you for an X-ray?”

  Jan shook his head. “Not cuts and bruises,” he whispered. “Not the bump on the head.”

  “So what is it that’s stopping you getting out of bed?” Geoff prompted.

  There was a pause. Jan looked at Geoff; surely the man could see what was wrong? He was a qualified nurse, wasn’t he? And his specialism was Mental Health?

  “You know, Jan, by rights you should have reported for duty half an hour ago,” Geoff pointed out mildly.

  “For duty?” Jan was horrified. How could he be expected to go on duty, to help the patients when he himself was. . .

  “I’m too ill,” he said.

  “Ah, now we’re getting somewhere.” Geoff nodded. “Where are you ill?”

  Jan hesitated. He felt terrible in a general sort of way, but he couldn’t begin to describe any specific symptom.

  “I have a headache,” he said, though he hadn’t.

  “I’m not surprised,” Geoff said. “It’s this over-heated building. You should have come out for a run – that would’ve cleared your head.”

  “I couldn’t run,” said Jan. “I am too tired – terribly, terribly tired.”

  Geoff nodded, apparently sympathetic. “You’re all the same, you students,” he said. “So used to sitting on your bum all day, the first week on placement knocks you out.”

  Jan couldn’t believe what he was hearing. He’d seen himself in the bathroom mirror, knew he looked ghastly – sheet-white, gaunt, patches under his eyes black as bruises. Why couldn’t Geoff see this?

  “I am ill,” he said, quite loudly this time.

  “How?” Geoff repeated.

  Tears welled up from Jan’s eyes; swallowing a sob, he pointed to himself.

  “In here,” he gasped, pounding his chest. “And here,” pointing to his head. “I am so sick and so tired I can’t get up.” His head dropped, his whole body sagged, his hands dropped down on to the bed and he felt the tears drip down his pyjama jacket. “Don’t you understand?” he asked.

  “Aye, lad, I understand.” Geoff leaned over and patted Jan’s thin shoulder gently. “Point is, do you?”

  There was a long silence, then Jan looked up, wiped his wet face, and nodded. “Yes,” he said. “I understand that I am ill inside myself, in my soul, mayhaps.” He took a deep, shaky breath. “Mentally ill,” he said. And he sat back with something like relief.

  “Well, now you’ve admitted it, you’re on your way to getting better.” Geoff smiled and nodded at him thoughtfully for a moment. “So, you’re in a funny old position in this department, aren’t you?” he said. “No longer a student nurse – more a patient.” He laughed. “What are we going to do with you?” he asked.

  “I hope you’re going to make me better,” said Jan, smiling painfully.

  “Nay, lad, we can’t do that. I’ve told you – in the end that’s up to you.” He turned to the door. “And Dr Hammond, of course. That’s why I want you in my office at nine o’clock. Dr Hammond’s popping in to have a chat with you – right?”

  He stared at Jan. Jan stared back then slowly, hesitantly, he nodded.

  “I will come,” he said.

  Chapter 9

  And so Jan was transformed from student nurse to hospital patient – or so he thought. Dr Hammond prescribed largactil, Geoff prescribed rest and quiet and Karen provided the back-up service. It seemed to Jan that all he had to do was to keep on taking the pills, ask Karen to make the occasional coffee, and shut himself up in his room alone, dozing and dreaming day and night.

  But he soon found there was a price to pay.

  “You can take the run tomorrow,” Geoff told him towards the end of the week. “I’m off.”

  “Off where?” Jan asked.

  “Off – you know, as in ‘day off’.” “I came in last Saturday night, worked over Sunday, didn’t I?”

  Jan shook his head; he couldn’t remember last Sunday – or even last night. Didn’t want to.

  “Doug Bellamy’s on but he won’t take the run. Plays it by the book, does our Doug.” Geoff leaned over and patted Jan’s back. “So, it’s up to you, lad.”

  Jan stared stonily out of the window. “I can’t.”

  Geoff ignored him. “We’ve just got a nice little group going now – don’t want to lose ’em. They soon get out of the habit, you know – miss a couple of mornings and never get up early again.”

  Jan sighed. “But I am ill,” he protested.

  Geoff nodded. “Aye,” he agreed. “And this is one way of getting better.” Ignoring Jan’s stricken face, he went on, “Don’t go pressing them too much – especially not Karen; she soon overdoes it. Martin’s your pace-maker – slow but steady, could keep on for hours.”

  “I can’t go,” Jan turned his back on Geoff.

  Geoff said nothing and he never moved. Eventually Jan turned over to see what he was doing. He was sitting in the single armchair, apparently dozing, but as Jan sat up his eyes opened.

  “I was thinking,” he said, “that if you go on working with the group, living here for a bit but keeping all your notes for your assignment, you could pass this placement with flying colours.”

  “Colours?”

  “Aye – you know, as in flags.”

  Jan frowned. “I don’t understand,” he said.

  “Right, I’ll explain the reference; where’s your notebook?”

  Jan looked vaguely round. He had no idea where the notebook was; he hadn’t even noticed a new word for days.

  But Geoff flipped through all the papers on the dressing-table and soon came up with the little red book. Further search revealed a pencil.

  “Now then, ‘flying colours’,” he said. “Ready?”

  Jan blinked at the white page, took the pencil in his shaking fingers, and began laboriously to write as Geoff expanded on the theme of flags and warfare as if Jan was a military student, not a nurse. Jan looked at the wobbly letters on the page and wondered why he himself was bothering. Why Geoff was bothering. . .

  Nevertheless, he went on writing, and drawing the little flags as Geoff described them, and he noticed his hand grow steadier, his interest ever so slightly roused. Ah – occupational therapy – that’s what Geoff was up to! Jan glared at him and stopped writing.

  But before he could prot
est he was interrupted by a knock on the door.

  Head bowed, Jan quickly turned his attention to his notebook.

  “Go on,” urged Geoff. “Tell ’em to come in.”

  Jan looked round the small room, made even smaller with Geoff’s bulk spreading over the arm-chair, his legs sprawled out, filling the only space.

  “There is no room,” he pointed out.

  “That’s all right – I’m just leaving.” Geoff stood up. “Go on,” he said again. “It’s your room – I can’t invite anybody in.”

  Jan sighed. “Come in,” he muttered, unwelcoming. After all that therapy nonsense from Geoff, he really didn’t feel he could face another visitor.

  Especially not Claire Donovan.

  “Oh, I’m very sorry,” she said, pausing in the doorway. “I didn’t realize you were busy.”

  Jan looked helplessly at Geoff, but he moved over to the door.

  “Nay, lass, I’m just off.” He turned and grinned at Jan. “See you Monday,” he said. “And don’t forget that run.”

  He left a space behind him – a silence too. Jan slumped back on his pillows, avoiding Claire’s eyes, as she went across to sit down.

  “How are you feeling?” she asked.

  Jan shrugged.

  “Are you feeling better than you did last weekend?” she persisted.

  “I don’t know,” he said, truthfully. He didn’t want to remember how he’d felt last weekend.

  There was a pause – a long pause. Jan stared at the wall at the end of the bed, Claire fiddled with the plastic bag on her lap.

  “I’m sorry I didn’t come to see you sooner,” she said eventually.

  “It is all right,” Jan assured her. It was more than that, he reflected; it was quite a relief.

  “I thought maybe you needed a breathing space,” Claire went on, her voice so quiet and low that he had to strain to hear it. “You see, in some way I feel responsible for your . . . breakdown.”

  She’d said it aloud. It was the first time Jan had heard his condition labelled. Dr Hammond was very careful to avoid labels – “stress”, he’d called it, and something called “PTS”, which, he’d explained, often happened to people who’d come through a particularly bad experience. “Post-traumatic Syndrome”; Jan recalled the words, took comfort in them.

  “It is stress,” he said coldly to Claire. “We do not use the word ‘breakdown’ here.”

  Claire flushed. “I’m sorry,” she said.

  “And you are not responsible,” he went on. “It is stress from the battles, from leaving my country, my home, my. . .” “Family,” he wanted to add, but dared not. Even to think of them would start up the tears. “You must not blame yourself,” he added rather severely. Then, to his own surprise, he said, “I am getting better now.”

  “Good.” Claire looked at him doubtfully and he knew she was noticing his black-ringed eyes, his haggard face, his hands, trembling again already. Swiftly he shoved them under the covers and grasped one in the other, to hold them still.

  “Well, I am better than last weekend,” he assured Claire, making a ghastly attempt to smile. “So much better that tomorrow I am in charge of the early morning run.” Again, the words took him by surprise.

  “Good,” said Claire doubtfully. “So when are you coming back?”

  The smile collapsed. Why was everyone so keen for him to go back to where he didn’t want to be?

  “Back?” he asked, playing for time. “Back where?”

  “To Kelham’s, of course,” she said. “To your friends.”

  Jan didn’t answer. It seemed to him that Kelham’s and The Six were part of a different existence now. They might have been on another planet. He couldn’t even imagine himself taking the journey across the grounds. In some ways Czerny seemed closer.

  “I must stay here,” he muttered.

  “As a patient?” Claire asked, sharply. “Or as a nurse?”

  There was no answer to that. Jan shrugged and turned away from her.

  Claire took a deep breath. “You see, I do feel responsible. I think your – er – trouble started over in Donegal. Maybe it was the flight that triggered off something, or perhaps it was just the holiday that did it – relaxing and all. . .”

  “Ah, so you are a psychiatrist?” Jan sneered.

  “No, I’m not,” Claire said quietly, and Jan immediately felt guilty. “But I have been thinking, Jan, about you – about us.” She paused, as if giving him the opportunity to interrupt. He didn’t, so she went on. “You may be right to stay over here for a while, whatever your role. Things are always hectic over at Kelham’s; we’re not the most restful company, I know.” She smiled. “And I think that’s what you’re needing now, Jan – a rest – from us all.”

  Silence. Jan could hear the spatter of rain on the window, the steady hum of the central heating system, and far away, down the corridor, a familiar “toc-toc-toc” of heavy rubber boots.

  “So you see,” Claire stood up, “you mustn’t be worrying about me – about us. We’ll just take a little holiday from each other – see how things are when you’re feeling better.”

  She leaned over the bed to look into his eyes. And all the time he was aware of the footsteps getting closer.

  “Bye, love,” said Claire. She took his hand and held it up to her face. “When – if – you want to see me, just tell one of the others.”

  Jan could scarcely breathe. When the knock came at the door, he couldn’t even call an answer.

  “Jan? You there, love?” Karen’s voice sounded clearly through the door, cheerful and chirpy as it always was when she was on a high.

  Jan sat up and pulled his hand away from Claire.

  “Come in!” he called brightly.

  She stood in the doorway, a vision of leather and metal, her short, blonde spikes around her head like a halo.

  “Hi!” she lifted a hand to Claire. “You one of his nursing friends?”

  “Yes, I am,” said Claire, though she was still looking at Jan. “Just one of his nursing friends,” she said. And then she turned away, pushed past Karen and was gone.

  “Wow!” Karen whistled. “Did I interrupt something?”

  She wasn’t nearly so bright and bumptious next morning, Jan observed. Nobody was. Now he realized why they were so silent on the runs: merely getting out of bed used up most of their energy and they had none left for talking. When Martin had banged on his door that morning, Jan had turned his face into his pillow and groaned. He couldn’t get up, he told himself – hadn’t the strength to move off the bed, never mind run along the track. But Martin had persisted and Jan, afraid he would awaken the whole corridor, struggled into his track-suit and out to the foyer where half a dozen runners awaited him.

  And now they were spread out along the track – Karen leading, pressing hard as usual, though she looked as if she’d hardly slept all night, Martin mid-field, staring straight ahead, pushing one foot in front of the other, one-two, one-two. . .

  From the end of the line, Jan watched and remembered that feeling of being on automatic pilot. The feeling he’d had when he’d run to the Mental Health Unit, away from the fire and the bangs of the fireworks.

  The feeling he’d experienced at Czerny Hospital, when casualties were arriving every second and the throb of heavy gunfire echoed relentlessly from the hills above the town. Jan closed his eyes for a second, as if to wash away the memories.

  And opened them sharpish as a cry went out ahead. Putting on a spurt, he caught up with a cluster of people by the copse.

  “Karen’s done a runner,” announced Alan, the oldest in the group.

  “Again,” added Margaret, jogging from foot to foot. “Shall we go and get her?” she added with relish.

  “We’d never catch up,” said Alan.

  Jan could feel his heart racing, the saliva rising in his mouth, the hint of nausea edging up from his stomach. Oh God, not now! Doug Bellamy had made it very obvious that he wasn’t happy with Jan’s dual r
ole on the unit.

  “So what are you, then?” he’d asked, apparently innocently. “A nurse off sick or a fit patient?”

  Jan had refused to answer then, but now he realized that if he didn’t cope with this crisis, he’d soon be classified – in Doug’s mind at least – as an unfit patient. Or, worse, as a mentally sick nurse, bundled back into the main hospital. And suddenly he knew he didn’t want either label.

  “Which way?” he asked, addressing Martin, who pointed off the track and into the woods.

  Jan hesitated. None of this group needed to be kept under supervision; Alan, for example, often came out running alone, as did Martin. But some of the patients were at their worst first thing, so it was accepted that they should be accompanied by someone from the staff – even someone as lowly as Jan. Doug Bellamy had expressed his doubts about Jan leading the run as soon as he’d arrived on duty that morning. If Jan sent them back unaccompanied. . .

  On the other hand, it was accepted that Karen was prone to doing a runner – and to harming herself in all sorts of ways. And yet, when she’d last run away from him up at the hospital, it was only to have a cigarette.

  “We’ll take the path up through the woods,” he said decisively. “You take the lead, Martin – as fast as you like. And everyone will smell.”

  There was a pause and Jan was aware of puzzled faces turning to him. He sniffed.

  “Like so,” he explained. “Karen will be smoking somewhere, I think.”

  “Ah! You mean we’re on the scent,” said Alan. And everyone laughed, partly at the joke, but mainly, Jan reflected, with relief. Relief at what? At having someone to take decisions? Well, he knew how they felt – wished he had someone to take a few decisions for him. No time now though.

  “Come on, then,” he said. “Off you go, Martin.”

  They ran on steadily, not fast, sniffing the air and smiling at each other – the first time Jan had seen them exchange any looks at all. And he understood now why they didn’t, why they rarely communicated. The blackness, the blankness, the utter exhaustion and the sleepless nights left them without interest in anyone or anything other than their illness. It was all-consuming.