There was an unwritten code which was rigidly followed in such matters. A student and a pro might smile at each other unremarked; a senior nurse and a houseman; a staff nurse and a registrar. But let a registrar look at a pro or the S.S.O. or S.M.O. glance mildly at any nurse, and the hospital would rub its hands and lick its lips in happily scandalised anticipation. Sisters were reckoned to be above and beyond such affairs; every nurse in training knew they were not. Every Sister had her pet Consultant, and most Consultants ‒ married or single ‒ their pet Sister. This was a pleasant scheme, since it ensured that the ward sisters were in a good mood at least twice a week, when their chosen Consultants did a teaching round. The S.M.O. and S.S.O., being only one step below the Consultants, were considered Sisters’ territory. They were also generally married. Dr Cutler, the medical officer, had three children and was charming to everyone; Mr Dexter, being a bachelor, was polite to all but charming to no one ‒ with the new exception, apparently, of Sister O.P.s.
He never so much as glanced my way when he walked into Out-Patients half-way through that morning. Sister, who was seated at a small table in the corridor directing patients, rose with a smile of welcome that was only temporarily dimmed when she saw me standing, quite officially, in the doorway, talking to the departing mother of one of the many infants I was shepherding out of my room.
Half an hour later Mr Rufford, the orthopaedic specialist, smiled at the small Australian boy I had just wheeled into his office.
‘Mr Dexter in the department, Nurse Snow?’
‘He’s taking Mr Makin’s (the general surgeon’s) clinic next door, Mr Rufford.’
Mr Rufford got up from his chair. ‘I’d like a word with him in a moment. I want him to look at young Randy here.’
Young Randy looked up at us. ‘More docs, Doc?’
‘More docs, chum,’ said Mr Rufford. ‘But you’ll know this one. Just let’s have you on that couch and we’ll see what we can do about those legs.’
He beckoned to Mrs Durant, Randy’s mother. She came over from the front bench and hesitated at the door of the glass-fronted office. She was a thin, tired-looking young woman, with a lined, sun-burnt face.
‘Come in, Mother,’ said Mr Rufford, ‘and take a chair. I want you to tell me how your boy has been since we discharged him? How’s he been in himself? Better than he was those last two years when you had him in that pram? Before I put this new plaster on?’
‘Oh, my word, Doctor,’ she said, ‘he’s been real good. And hungry. Eats like a horse.’
‘I see.’ He made a few notes, asked a few more questions. ‘I had another letter from your doctor in Australia. I wrote and told him what I had done. He sent you his regards.’ He found the letter among the notes. ‘From Masonville. That your home town?’
She said no. ‘Randy was in hospital there, Doctor, but we live in the out-back.’ She mentioned the place. ‘Randy had to fly there, he did, and I got in often to see him. They treated him real good. That so, son?’
Randy said, ‘Too right, it was.’
‘But he wasn’t getting any better, Doctor,’ she said urgently, ‘so his Dad and I decided he ought to come home.’
Mr Rufford nodded. He had heard all this from her before, but he was a patient man, and he listened carefully as if it was news to him.
‘Have you been out there long, Mrs Durant?’
‘Oh, my word, Doctor. I was born out there. My grandparents settled in Australia sixty years back. But we always call this home. And Doctor Mally ‒ that’s our Doctor out in Masonville ‒ he told us about you. He said you were the best man for legs in the world, he reckoned. So I brought him here,’ she added simply.
Mr Rufford was a small man for an orthopaedic surgeon. His line of surgery was one which required considerable physical strength in a surgeon and the majority were built on the lines of the S.S.O. Mr Rufford was small but square; his face was pink and cherubic. He looked suddenly older, as if he found Mrs Durant’s faith a great responsibility. He looked down at the notes on his desk.
‘It’s a long way to come,’ he said.
‘Oh, my word, Doctor,’ she said again. ‘I’d have brought him twice as far, if need be. He’s our only kid.’
‘I see.’ He smiled ‒ a shy smile. ‘Well’ ‒ he scribbled something on a fresh sheet of paper ‒ ‘we’ve done all we can to get him on his legs again’ ‒ he glanced up ‒ ‘you’ve seen he’s been having all that massage, haven’t you?’ She nodded, and he folded the sheet of paper and handed it to me. ‘Take that to Mr Dexter, please, Nurse. My compliments and I’d be obliged if he can spare a moment.’
Sister leapt at me as soon as I was outside the door.
‘Why are you not in your room, Nurse Snow?’
I explained and tentatively offered her the note.
‘And what makes you think I have the time to spare to deliver letters, Nurse?’ she demanded. ‘Get on at once and don’t keep Mr Rufford waiting! He’s a very busy man!’
‘Yes, Sister.’ I walked round her and into the next room.
Lisa was presiding there. She glided up the aisle between the benches of waiting patients, with raised eyebrows.
‘Wanting something?’
I said Mr Dexter. Her eyebrows rose even higher. ‘Does Sister know, Nurse?’
I said Sister did indeed. ‘Mr Rufford wants him.’
She sighed. ‘Oh dear. Another hold-up. He’s alone in the office ‒ I was just going to shepherd in the next patient, but you’d better have him first.’
‘Thanks, pal,’ I murmured, and walked on.
The general room had no glass office. I knocked at the wooden door. Mr Dexter called, ‘Come in,’ and when I went in, said, ‘Good morning, Nurse Snow,’ to the wall behind my head.
I told him why I had come, and handed him the note. He read it, then smiled faintly. ‘I’ll come now.’ As he came round the desk, he asked if I knew what was in the note.
‘No, Mr Dexter.’
‘Take a look.’ He held it in front of me.
It read: ‘I’ve got a worried mum here who thinks I’m a miracle worker. The subject is Randy Durant. I think I’m justified in providing a little drama, but I’d like a second opinion first. Toppling off a pedestal can be an unnerving experience.’
We went back to the Children’s Room office. Mrs Durant smiled uncertainly as Mr Rufford introduced John. ‘You know this Doctor, eh, Randy?’ said Mr Rufford.
Randy said fair dinkum he did. ‘Hi, Doc.’
‘Hi, Randy,’ said John gravely.
They looked at the old Australian X-rays, at the pictures taken when Randy first arrived, at the pictures of the operation, and at the wet plates taken this morning. They looked at Randy, who grinned back at them; they avoided looking at Mrs Durant; then they looked at each other.
Mr Rufford screwed up his face and resembled an elderly puck as he said, slowly, ‘I think ‒ off.’
Mrs Durant started, then sat forward on the edge of her chair, Randy’s face altered from a child’s to an adult’s.
‘You going to take me ‒ me legs off, Doc?’
‘Not your legs, son,’ said Mr Rufford, ‘your plasters.’
Randy hesitated. ‘I expect,’ he said, ‘I’ll need new ones, will I, Doc?’
‘Why?’ asked Mr Rufford. ‘Think you’ll be cold without ’em?’ He turned to Mrs Durant. ‘When did you last see him on his feet?’
She told him the exact date. I think she could have given the hour and minute had he asked for them. Her voice was unsteady. ‘It seems ever such a long time, Doctor.’
He smiled at her. ‘I’ll bet it does. Too long.’ His round eyes moved upward, ‘Eh, Mr Dexter?’
John said, ‘Too long. This chap’s’ ‒ he jerked a thumb at the boy ‒ ‘getting fat and lazy. Thoroughly pampered brat, aren’t you, Randy?’
Randy beamed. ‘Too right, Doc.’
‘Well,’ said Mr Rufford firmly, ‘what are you waiting for, Nurse Snow? Get the plaster shears o
ff that trolley. Come along.’
I handed him the waiting shears, saw John was removing his white coat, so I offered him another pair.
Mr Rufford said, ‘You got the time to do this, John?’
John said, ‘No,’ and went on with what he was doing.
Mr Rufford said it beat him that’s what it did, and the trouble with this hospital was the fact that the senior residents had too much time on their hands; and when he was a senior resident he never had time to put on a plaster, much less cut it off, which should be done by the registrar and housemen anyway.
‘And will you kindly tell me, Nurse Snow,’ he demanded, ‘just where my houseman has got to, and why, because my registrar has an examination this morning, my house-surgeon considers I am well able to dispense with his services at this clinic?’
I had been wondering this myself. I was about to say that I was afraid I had no idea but would ask Sister, when John answered for me.
‘Gilroy (the orthopaedic house-surgeon) is on the sick-list. Tonsils, or something equally infantile. Thanet is meant to be standing in for him, but he had to assist Mr Smith with the urological list first, and I’m afraid he must have been held up.’
Mr Rufford snorted. ‘Trust Smith!’
I was cheered by his sudden transformation into an irate Consultant. That meant he was satisfied. Mr Rufford prided himself on his bark; he liked to think we all trembled whenever he opened his mouth. On the contrary we much enjoyed his outbursts, they were never serious and were a sure sign that he was happy. When Mr Rufford was worried, he became the quietest and most civil of men.
It did not take them long to cut off that plaster: in a very few minutes John carefully lifted off the twin shells.
Randy twisted his ankles. ‘Feels real good.’ The poor child tried to sound casual, but his voice cracked. ‘Do I have to have another lot on right away?’
‘Oh, I don’t know,’ said Mr Rufford. ‘Let’s see you walk first.’
Mrs Durant jumped up. John had his back to her, but he felt her moving, caught my eye, and shook his head slightly. I stepped back and put my hand on her arm.
‘Sit down,’ I said very quietly, ‘and don’t say anything.’
She dropped back in her chair, her lips pressed firmly together, her back straight. Cautiously she reached for my hand that was still on her shoulder, and gripped it momentarily.
‘Slippers, Nurse,’ said Mr Rufford.
We had an assortment of slippers waiting on the bottom layer of the clinic trolley. I looked at Randy’s feet, guessed threes, and fitted that size on him.
‘How’s that, Randy?’ I asked.
‘That’s great, Nurse.’
‘Come along, come along,’ said Mr Rufford, ‘who do you think you are young fellow? Cinderella? Up you get.’
Randy stared, ‘Up? Right now?’
‘Right now. Up on to those two feet. And see here.’ Mr Rufford opened the office door wide. ‘See that girl over there? The one with red bows? Well, you just walk over to her and ask her to give you one. Dessay she won’t ‒ but you ask her.’
‘I’m to walk?’ Randy propped himself forward, and touched John, whom he knew well from his sojourn in Christian. ‘I can? Really, mister?’
John said gently, ‘Really, chum. Your legs are mended now and you’ve always had two good feet. You just try. You can do it.’
Randy looked from one man to the other, uncertainly. Then he turned to his mother. ‘Mum ‒ did you hear what they tell me?’
Mrs Durant raised her head and smiled. ‘I heard,’ she said, ‘I heard. Good news, Randy. Think what your dad’ll have to say about this. He’s going to be pleased.’
She was wonderful, that woman. She was white with anxiety, but she answered him as calmly as if he had asked her what time it was.
Mr Rufford half turned away from Randy, and picked a blank history sheet off the desk. ‘What do you think of this, John?’
John looked closely at the sheet of paper. ‘That’s interesting.’
Randy watched them, but as they were not apparently paying any attention to him, he decided he might as well get up. He sat forward, pushed aside the shawl that had been covering him, and climbed alone off the couch. The two men were very close to him, but they did not touch him. I was holding my hands behind my back, and I found I was gripping my own wrist in my effort to keep my hands where they were.
Mrs Durant was holding her handbag in her lap. I saw her knuckles were white, but she never moved or uttered a sound. She sat there quietly as if it was the most normal thing in the world for a child to walk after all that time in plaster. And that child was her son.
Randy was on his feet. He swayed only once, and glanced again at the surgeons as he steadied himself on the side of the couch; but the men were not bothering with him, they were engrossed by their piece of paper; his mother was now searching for something in her bag, and I was apparently watching the rows of waiting children on the benches outside the glass wall. Randy nodded to himself, experimented with one foot, tried the other, then grinned swiftly. Of course walking must be dead easy; why fuss? The docs had said he could walk, hadn’t they? So he walked.
As he left the office our four heads jerked upward as if we were puppets and someone had pulled our strings. We saw him walk slowly but steadily across the long room, heard him shout ‘Hi, Red Bow,’ to Red Bow, heard the triumph in his voice, and saw the increased confidence in his dressing-gowned figure as he returned, more quickly this time, to the office. He stood in the doorway, scarlet with effort and pleasure. ‘It feels great!’
Mr Rufford frowned awesomely, ‘Where’s my red bow?’
‘Oh, gee,’ said the boy apologetically, ‘I forgot, mister. Shall I go back and ask her?’
Mr Rufford relaxed, ‘You go back, son, but don’t bother to ask her. I was just teasing you. But you take another walk.’
Randy was gone before he finished speaking.
John said, ‘I’ll have to leave you.’ He shook hands with Mrs Durant. ‘Good-bye and good luck.’
‘Oh, my word, Doctor,’ she said, ‘I don’t know what to say or how to thank you.’
He smiled. ‘I haven’t done anything; it’s Mr Rufford here who’s done it all ‒ and that boy of yours. He’s a good boy, that, but I expect you know that already.’
She said, ‘I do, Doctor, but thanks, thanks all the same.’
Mr Rufford got out of the doorway, ‘Thanks, John ‒ do the same for you one day.’
John smiled at him without answering, then walked quickly across the room, waved at Randy, and disappeared through the open door.
Mrs Durant stood up. ‘I can’t begin to say what I feel, Dr Rufford ‒’
‘Then don’t say anything, Mother,’ he said briskly, ‘just sit down again and listen to what you must do. You’ll have to take your boy along to the physiotherapist again this morning and give her the note I’ll write now. Then keep on with those appointments and the exercises I told you before; come back and see me in three weeks, and maybe I can hand you back to your doctor in Australia.’
She sat down and controlled her face with an effort.
‘He won’t have to go back to being in a chair? He’ll be all right? Really?’
‘He will. But you mustn’t let him overdo things, so don’t throw away the chair yet. He’s got his confidence back, which is what we are aiming at this morning, so you’ll have your hands full in that direction, I’m afraid! My goodness, young woman! Here’s a fine time to cry, after sitting there good as gold the way you did just now! You dry those tears and stop worrying. You’ve had more than your share,’ he added kindly. ‘You write and tell your husband that you’ll both be back for the New Year and tell him from me that he’s got a splendid young woman for a wife. Now then,’ he swung round and glared at me as I was redressing Randy after having caught him with considerable difficulty, ‘now then, Nurse, don’t dawdle! Send young Randy on his way with Mrs Durant.’ He shook hands all round. ‘Goodbye, R
andy ‒ see you once more, maybe twice ‒ good-bye, Mrs Durant; don’t bother to thank me, thank you for coming. Nurse Snow! I can’t hang around all day waiting for my next patient! Who’s next? Red Bow? Or Dorothy?’
‘Dorothy Bland.’ I had pushed the protesting Randy back into his wheelchair with the promise that it was only for the ride to the massage department, and was handing Mrs Durant the mass of forms and notes that she would need to give the physiotherapist and the Out-Patient almoner. Mrs Durant tucked the notes under her arm.
‘You know, Nurse,’ she said softly, ‘I’ve thought I’ve been happy before. But until now I didn’t know what happiness was.’ She sailed away, pushing the wheelchair in front of her, and the children on the benches turned their heads to smile at her, and even her back seemed to glow with relief and wonder.
Mr Rufford said, ‘Ask Mrs Bland to come in with Dorothy, please, Nurse.’
Mrs Bland was surprised at my request that she should accompany her eight-year-old daughter, who sat straight as a guardsman in her spinal jacket.
‘Me too, dear? Ta, Nurse, I’m sure.’
It must have been Dorothy’s first follow-up clinic, or Mrs Bland would have known that Mr Rufford insisted on the mothers of his child patients being present when he looked at their children. Not all our doctors agreed with him on this point, but he was adamant, and had explained his outlook to us in his lectures.
‘When I send a child home,’ he had said, ‘I hand over the case to the mother. If that mother isn’t working with me, then I’ve wasted a good deal of work and time. So I just treat the mums as normal intelligent human beings, and you’d be surprised how many of them are that! I tell ’em what I want done and why. In ninety-nine cases out of a hundred it works. Works very well.’
Mr Rufford’s patients did very well. Certainly orthopaedic surgery is a branch in which a hundred per cent cures are cures and not limited to a five-year period; but even among orthopaedic surgeons Mr Rufford and his statistics were considered outstanding. We often wondered how much of this was due, not only to his skill, but to his sympathetic personality. He was also an unconscious mimic. He could talk pure Elephant and Castle, straight Geordie, or assume a Dublin accent automatically, depending on where his patients hailed from. The patients were invariably delighted and at ease.
The Quiet Wards Page 7