The Silent Valley

by Jean S. MacLeod

  The room was very still. The old-fashioned steriliser which Matron wanted replaced sputtered somewhere behind her, but that was all. Paralysing fear closed in Jane's throat as her eyes went instinctively to the deflated balloon above the anaesthetist's chair and she realised that the woman on the table was dead.

  Pale and exhausted, the anaesthetist himself appeared to droop at the head of the table, and Stella Oakroyd was wheeling the useless oxygen cylinders away. Stuart, too, seemed momentarily paralysed, and then, with a swift, impervious gesture, he signalled Stella back to the table and lifted a small lancet from the tray. The light glanced across it as he made the first incision under the patient's heart.

  Jane stood where she was with the blood plasma still clutched in her hands, rooted to the spot in wonder and admiration as he gently manipulated the silent heart, massaging it with those long, slender fingers.

  He worked without any sign of emotion for twenty minutes and then she knew that the battle had been lost.

  Tight-lipped, he sutured up and turned away. Defeat lay grimly upon him, on the sealed mouth and hard, expressionless eyes. Nobody spoke. Jane felt the minutes, like weights, pressing relentlessly against her temples, and then Stella Oakroyd crossed to her side and took the plasma bottle from her.

  'It's too late,' she said unnecessarily. 'Finish up in here.'

  Jane's whole body began to tremble. She had seen death before, but not like this. The whole theatre seemed to be hazed in a thickening mist, but she knew that she must not faint. Stuart passed her, seemingly without seeing her. He had lost a life.

  It's dreadful, she thought, to go out like that—so swiftly, like a blown candle.

  They wheeled the body away, Stella and the ward orderly, but she still stood there, staring at the floor. In these first moments she wondered if the blood transfusion would have made any difference, blaming herself wildly for the mistake that had been made. I can't bear it, she thought. I'm not cut out for the suddenness of this sort of thing—its utter ruthlessness.

  'Pull yourself together, Jane,' a kindly voice advised, but it seemed that she was looking at Stuart through an obscuring mist of pain. 'It was one of those unfortunate sets of circumstances which we stumble upon all too frequently in our profession. The trouble had gone much deeper than I guessed. Nobody can really be held responsible.'

  Yes, there had been kindness in his voice, but there had been remoteness, too, and in spite of the kindness she was remembering the look in his eyes when he had faced her across the table and commanded her not to make mistakes. Would the correct blood transfusion in the first place have bridged the gap between life and death? She shuddered away from the answer. It might have done!

  Automatically, she bent down to pick up the discarded swabs. So much to do; so much already done! How old would the woman be? Forty at most, she guessed. Forty, and unmarried. She could visualise the chart she had made out the day before. 'Anne Cowrie, spinster, aged forty-one....' The woman could not have been completely alone in the world. Jane remembered a sister, a tired woman with fear in her eyes.

  Shivering, she switched off the remaining lights and went through the swing doors, hearing the soft swish of them closing behind her with a strange finality.

  There was still work to be done in the ante-room and she turned to it automatically, and not until the floor was swabbed over and the towels stacked beside the steriliser did she look at her watch. It was one o'clock.

  The food trolleys were being trundled along the corridor from the lift, punctual to the minute, but the thought of food was suddenly revolting. The door opened and the anaesthetist put his grey head into the room.

  'Don't take all this too much to heart,' he advised at sight of her pale face and darkly-shadowed eyes. 'We did everything we possibly could, you know. The heart was very weak. It didn't even respond to massage. Hemmingway tried everything in that last desperate effort—coromine, oxygen, massage—the whole bag of tricks. He fights to the very last ditch.'

  She tried to smile. Somehow, she could not bring herself to ask him if the transfusion would have made any difference.

  'Go and get yourself a strong cup of tea,' he advised. 'It will do you a world of good. I'm sorry I spoke so harshly about the blood,' he added, 'but Hemmingway abhors carelessness, even in details. Even though it wasn't really needed, after all, he would consider it important.'

  Was he trying to reassure her, to wipe out the consciousness of something that was irrevocable?

  She went to her room, because she couldn't face the others in the dining-room, where death was a commonplace.

  By two o'clock Matron had sent for her. Jane's feet began to drag as she walked along the corridor and she felt empty inside.

  Matron was sitting in her usual position at the desk near the window, with her back to the light so that it fell directly on her visitor's face, head up, body stiffly erect, commanding brown eyes on the victim across the room. Today, however, there was more than criticism in the look she gave Jane. There was something stony about it, as if her mind was already made up about her course of action, her determination about the future unshakably strong.

  'I think, Sister,' she began, 'that you will not be surprised at what I am about to say. A mistake has been made in the operating theatre and it is my duty to sift, it to the bottom.' She looked down at the pad of notes lying before her. 'Can you tell me who checked out the first bottle of plasma this morning, the one you had to change during the course of the operation?'

  Jane moistened dry lips. There was nothing for it but the truth, and probably Matron already had the information, anyway.

  'Doctor Sark.'

  The dark eyes opposite looked straight through her.

  'You realise, of course, what you are saying?'

  'Yes, Matron.'

  The brown eyes did not waver.

  'Would it interest you to know that the blood was never booked out?' Agnes Lawdon demanded.

  Jane felt her heart contract, but there was no reason for her to appear dismayed.

  'Doctor Sark gave me the plasma,' she reiterated steadily.

  'And you saw him initial the bank book?'

  'No.'

  The quiet, damaging monosyllable echoed through the room like the first whisper of defeat, which indeed it was. Matron raised her grey eyebrows a fraction of an inch, but her face was still almost expressionless.

  'That would be the correct procedure,' she observed impartially. 'Any withdrawal from the safe must be notified. In that way there can be no room for error.'

  'I did notify it,' Jane protested. 'I asked Doctor Sark for the plasma. If I didn't check it, perhaps that was my fault, but I did ask for group A.'

  Matron's slight movement was just perceptible. She leaned a fraction of an inch nearer across the desk.

  'I am going to suggest to you, Sister, that Doctor Sark was not in the office at all when you took that blood,' she said.

  The measured tones were those of suggestion, and Jane stared at her incredulously as she added with increased deliberation:

  'Furthermore, I suggest that you also exchanged the plasma on your own initiative when you were sent out of the theatre by Mr. Hemmingway. That morning I had given Doctor Sark some slides—cultures he wished to study under the microscope. I put it to you, Sister, that he was downstairs returning those slides when you went for the plasma and you had left your final preparations in the theatre too late to wait for his return and helped yourself.'

  'No!' Jane gasped. 'No—that isn't true! Doctor Sark had the microscope set up in the office. He was studying the cultures when I went in.'

  'Are you trying to suggest that a doctor so forgot his duty as to hand you the wrong blood plasma?' Agnes Lawdon demanded icily. 'Who took the bottle out of the refrigerator?'

  'I did, but ‑'

  Suddenly Jane recognised the futility of all argument. There was cold fury in Matron's voice, and she had a sudden vision of two accusing brown eyes fixed on hers over Stuart Hemmingway's b
road shoulders as Matron had followed him into the theatre and Tom Sark had released her and gone his way.

  It was useless, she thought. Denial would gain her nothing until Tom came forward with the truth. She had expected to be questioned, but Agnes Lawdon was fair-minded enough to thresh everything out to the final detail. That was true, wasn't it? She looked across at the tightened expression on the older woman's face and thought that Agnes Lawdon's mouth looked curiously contorted for a moment, as if a mask had been ruthlessly pulled away, but in the next instant the older woman was saying coldly:

  'You are evidently not willing to be truthful, Sister, I feel that it amounts to that, but my duty is with discipline. I cannot let this mistake pass unchallenged.'

  Jane was staring at her now, seeing her and not seeing her, conscious of defeat with an overwhelming sense of its inevitability.

  'I had not expected you to try to shield yourself in this way,' the icy voice went on. 'When a mistake has been made the only honourable thing to do is to own up to it.'

  'But I don't feel that I have made a mistake—not in the way you mean.' Jane was herself again, determined to hold her own. 'I asked Doctor Sark for the blood and was given what he considered was the right plasma. I understood that he would sign for it after I had gone.'

  The cold fury in the older woman's eyes was replaced by a look of steely determination.

  'I must tell you, Sister, that there was no signature against either withdrawal,' she said with studied calm, icy in its intent. 'Apparently you took both bottles without authority, on your own initiative.'

  Once again Jane became acutely aware of suggestion, of pressure being added to an argument.

  'Doctor Sark may have forgotten ‑'

  'Are you not the one who has forgotten, Sister?' There was a leashed intensity about the tall, spare figure as Agnes Lawdon rose to her feet and bent forward across the desk, fixing Jane with those authoritative brown eyes. Her ears were apparently closed to all reasoning. 'Doctor Sark is a busy person. I am not going to insult him by trying to verify these wild statements of yours because I am quite sure he is not given to mistakes of such a nature. His training would be all against it. Besides,' she added with deliberate emphasis, 'a doctor's career can never be sacrificed to that of a nurse, however much in the right she may think herself to be. The two are simply incomparable. I'm afraid I consider you wholly responsible for a reprehensible mistake, Sister. Conyers is a private Home and our reputation could be endangered by the result of such a mistake as you have made this morning. I have no alternative but to ask you to let me have your resignation.'

  Jane drew back aghast. She had expected a reprimand, but not this.

  'You can't mean it!' she cried. 'You couldn't be so—cruel, forcing me to face such a responsibility when I've told you the truth.'

  Agnes Lawdon straightened to her full, commanding height. Jane had never realised how tall she was before, nor how ruthless.

  'Whatever you feel, the facts remain. You cannot, without evidence, shift the blame on to Doctor Sark.' She leaned forward again, her hands clenched tightly on the polished wood of the desk until the knuckles showed white through the taut, dry skin. 'What is your future compared with that of a rising young doctor?' she demanded. 'Unless Mr. Hemmingway is entirely satisfied that the blood transfusion would not have helped at all, this will all come out at the inquest. It is for him to decide.'

  'But the woman's heart failed,' Jane protested. 'Even if transfusion had been given right away, it would have proved useless. It takes all of an hour to work.'

  Her mind was quite clear now. She was not so much reassuring herself as stating a fact in her own defence, but she saw that Matron was no longer prepared to listen. The operation was not the real issue. It was Tom Sark and that meeting at Crale, and Tom again in the ante-room before the operation began. Matron was acting according to code, but somehow Jane knew that she was also shielding Tom.

  'You may go now, Sister.' The coldly precise voice sounded far above her head. 'You will not be needed in the theatre again.' Jane clenched her hands to keep them from trembling as she turned away, but before she reached the door she swung round to face the woman on the far side of the desk.

  'I can't expect you to believe me now,' she said, 'but what I have told you is the truth—every word of it.' In spite of her effort at command, her pale lips quivered. 'Have you never made a mistake, ma'am—never in all your life?'

  The question did not seem to reach Matron, for the hard face remained in its set lines, but suddenly the eyes wavered and weakened. It was only for an instant, however, and if Agnes Lawdon had looked into the past in that split second of remembering, she was as swiftly in control of the situation again.

  'Discussion remains useless, Sister, and singularly unpleasant in the circumstances,' she observed. 'It cannot alter facts. A serious mistake has been made, and I shall not permit you to tarnish Doctor Sark's reputation to save your own. Your respective careers are not to be considered in the same breath.'

  Yes, Jane thought briefly, that was it. Scapegoat!

  There was a problem, too, at Heppleton, the problem of how to break her news to Hazel. Her sister's happiness was so obvious, and in less than a month Hazel would be starting a new life, but if she was not to go back to Conyers there would have to be some sort of explanation of the position. Matron would terminate her contract within a week, and before that happened she must make her decision about the future.

  Hazel's wedding preparations were so well ahead that she even considered the possibility of not telling her at all until a chance remark from Eric Bridgewater decided her.

  'Everything's set!' he observed with complete satisfaction, coming into the house as if he owned that, too. 'Nothing can alter your decision now, Hay. You'd have me to reckon with if you so much as tried!'

  Jane supposed that was how it should be, but the next few days at Conyers were agony for her. There seemed nobody in whom she might confide. She tried to appear normal and must have succeeded up to a point, because the news of her dismissal did not leak out right away. For once the corridor grape-vine appeared to be out of action. The excitement was mostly centred on Della Cortonwell and the fact that she had refused, point blank, to remain at Conyers a moment longer. Stuart, it was rumoured, had reasoned with her, but all to no avail. Life in the confined and regulated atmosphere of a nursing home irked Della beyond endurance and she would have no more of it. She was going home.

  'The girl's a fool, of course,' Matron said dispassionately, but Jane did not think that Della was a fool. She thought that she could understand the desperate motivating force which drove Della to appear normal, to take up the threads of life again so that Stuart might continue to love her.

  Jane saw Stuart twice during those unhappy days, on his way to the operating theatre, but he passed her without a word, acknowledging her with the briefest of nods, as if he was too preoccupied with other, more important matters to remember the incident which had altered her whole life. To her complete surprise and absolute relief she was not called as a witness at the inquest. Stuart, it seemed, had given a complete and satisfactory account of the circumstances leading to the woman's death and there was no question of censure.

  On the Friday Tom Sark sought her out deliberately. She had been conscious of avoiding Tom, but when he came to the nurses' pantry where she was alone, she was forced to stay and listen to what he had to say.

  'Look here, Jane,' he began impetuously, 'what's all this about you leaving us? Matron mumbled something about it this morning when I asked if you were still in the theatre.'

  Jane had the distinct feeling that Tom suspected something and could not exactly put a name to it, but nothing would be gained now by letting him discover the truth. She felt that she could not go on working at Conyers, in any case, because the strain of seeing Stuart day after day was likely to be come too great.

  'It's quite true,' she said as calmly as possible. 'I am leaving.'

  'What's
happened?' he demanded. 'Got a better berth somewhere else?'

  His manner suggested that he might not be averse to such a possibility and he did not quite meet her eyes. Did he know about the blood transfusion? The instant's suspicion was followed by shattering disappointment, crowding in to choke further utterance. Did he know about it and was keeping silent? She looked at him and felt empty, drained of all emotion. What had she really expected of him? That he should rush to her aid, confessing his own negligence in the matter? Well, he hadn't done that. He had saved his own skin, and Stuart had decided that there was no need to mention the transfusion at the inquest, so the matter would rest there. Everything had hinged upon Stuart's decision, but she knew that he would do only what was right. How far he towered above the common herd! Her heart caught at the thought of him. Was this to be her everlasting regret, the knowledge of the might-have-beens ?

  In a clumsy sort of way Tom tried to make amends. When she told him she had no other job, he said:

  'Don't worry too much, Janey. Things will straighten out. They always do.'

  He ran her home and Hazel asked him to stay for tea. When they went through to the kitchen to prepare it, leaving him to amuse Linda Jane on the sitting-room hearthrug, Hazel said:

  'Is there anything wrong, Jane? You look like death. Has something come unstuck at Conyers?'

  Jane was at the sink, filling the kettle.

  'I've given up my job,' she said.

  'Oh, Jane—why?'

  'I—I needed a change.'

  'But you were so happy at Conyers!'

  Jane laughed, a dry, almost harsh sound. Yes, she had been happy at Conyers. She had considered it her job for life.

  'It's—not because of me?' Hazel asked hesitantly. 'Because I'm going away to be married?'

  'Good gracious, no!' Why did everyone think the world revolved about their own actions! 'It has nothing to do with your or Eric, Hazel. It's just that—one can be too long in a job, I guess.'

  'But what are you going to do?'