Children's Ward

by Claire Rayner

  And when, last thing that night, before she went to bed, she opened her parcel from Gregory, to find another tiny porcelain figure, this time of a dark haired boy leaning over a stile, a cap on the back of his curly head, his tiny legs crossed nonchalantly, his brown eyes looking cheerfully out at the world, she smiled. There were no tears in her this time, no feeling of misery as she looked at the pair of little figures where she set them on her dressing table. For there were two of them; and despising herself a little for her own lapse into superstition, she saw them as a happy omen.

  Chapter Five

  Christmas Day at the Royal followed its time-honoured pattern. Those adult patients who were well enough came in their pyjamas and dressing gowns to the children’s ward to watch the excited opening of stockings; nurses snatched minutes from their own wards to trail happily round the hospital admiring the decorations other nurses had put up; the Theatres were full of hilarious doctors stuffing themselves with mince pies and coffee long before ten o’clock; the local Mayor and various dignitaries came to make their usual pompous tour of the wards, and in the kitchens, cooks and dieticians sweated hectically over the dozens of colossal turkeys and plum puddings, working against the clock to have the patients’ Christmas dinner ready by noon.

  Harriet, trying against all odds to get the usual dressings and treatments done on the children’s ward, in a welter of paper wrappings, dealt with those children who managed to eat themselves sick soon after breakfast, and turned a blind eye to those of her nurses who left the ward more often than they should have done on visits to other wards. Christmas Day was one day when a Sister expected to carry the main burden of the ward work, and she didn’t really mind having to work so hard – this was one of the nicest parts of being a children’s ward sister, and she was happy.

  At three o’clock, when the parents filled the ward, and as many of the staff as could had arrived to watch the fun, Dr Bennett, sweating uncomfortably in his red suit, jumped through the fire escape door with many loud ‘Ho-Ho’s!’ and a deep ‘Hello Children!’ to distribute the presents from the tree, accompanied as usual by the brawniest medical student who could be found, tastefully dressed in a fairy costume from beneath which hairy legs adorned with football socks and boots capered cheerfully from bed to bed, hugging the children, and kissing every nurse he could catch. Harriet, in her place beside the tree, ready to hand the parcels to Dr Bennett, was just about to begin the job, when the ’phone made itself heard, ringing shrilly above the shrieks of the children, and the giggles of nurses busy dodging the enthusiastic attentions of the fairy. The Staff nurse answered it, and came picking her way through the crowd to whisper in Harriet’s ear.

  ‘There’s a child with virus pneumonia on her way up, Sister. Dr Weston’s bringing her –’ and with a sigh, Harriet relinquished her place beside the tree to her staff nurse, and hurried out to a cubicle to prepare for the admission. She always hoped nothing of this sort would happen on Christmas Day, but all too often, it did. Illness was no respecter of occasions.

  As she finished opening the cot, setting the electric blanket to warm the sheets, Gregory appeared at the door of the cubicle, a small child held in his arms, an anxious man behind him.

  ‘Acute virus pneumonia,’ he said shortly, carefully laying the child into the cot. She was very small – barely a year old, and her face, an olive skinned pointed one, with the liquid brown eyes and curling black eyelashes of the Greek Cypriot, was waxy, with tinges of blue round the pinched nostrils, which flared with each struggling inhalation as the child fought to breathe. Her curly black hair was sticking in tendrils to her broad forehead, and she whimpered miserably, struggling weakly against Harriet’s gentle hands, as she began to take her clothes off, putting a small gown on the narrow olive-brown body.

  ‘She’ll need oxygen –’ Gregory was saying, ‘and some antibiotic – can you get a tent up while I fix a jab for her?’

  Harriet nodded, and with rapid movements, pulled an oxygen cylinder towards the bed. Gregory disappeared towards the sterilising room, while carefully, Harriet fixed the small mask from the cylinder over the child’s face, and turned to the man hovering anxiously beside the cot.

  ‘You are her father?’

  ‘Huh? Father – yes, father – speak – no English –’ the man said, crouching beside the cot to peer with frightened eyes at the small girl tossing a little on the white pillows. ‘Anna – my Anna – you make well?’

  ‘We’ll try –’ Harriet said gently. ‘Please – hold this. I must get a tent up –’ and carefully, she put the man’s hand on the mask, showing him how to hold it in place, before hurrying to fetch the big polythene oxygen tent, the ice and spare cylinder that would be needed to surround the child with the oxygen she needed so desperately.

  She had the tent up round the cot before Gregory returned with an injection ready on a tray, and together, with their arms carefully pushed through the special apertures at the side of the tent, they thrust the fine needle into the small buttock, and as the child squirmed feebly and whimpered, sent the plunger into the barrel, to fill the blood stream with a million units of penicillin.

  Beyond the glass-walled cubicle, Harriet could hear the shouts and laughter of the children, the deep voice of Dr Bennett calling names, the squeals of joy as the beefy fairy capered from bed to bed, bringing each child to Santa Claus to get his parcels. Above the tent, inside which small Anna lay breathing agonisingly quickly and shallowly, a bunch of balloons swung with incongruous gaiety, and the head of the silent father, now hovering with piteous anxiety against the wall, was outlined with a loop of gaudy paper chains.

  Gregory and Harriet stood silently, looking down on the child in the tent, at the half closed eyes beneath which a rim of blue-white could be seen, making her look sickeningly like a half-dead creature – as indeed she was. And as they watched, her face seemed to get bluer, her neck stretched backwards in an agonising effort to breathe, and her mouth opened in a grimace of pain.

  Swiftly, Gregory thrust a hand through the tent to feel for her pulse, as the child suddenly lay quite still, not breathing at all.

  ‘She’s in collapse –’ he said, and pushed the tent back with impatient fingers.

  ‘Start artificial respiration,’ he said shortly. ‘She’ll need a direct heart stimulant – where’re the other nurses? We’ll need help –’

  ‘They’re in the ward with Santa Claus –’ Harriet said, as she began a rhythmic movement of her hands on the child’s thin chest, trying to inflate the small lungs again.

  ‘Bloody Christmas –’ Gregory said with a flare of anger, ‘I’ll get someone –’

  As he turned to hurry from the cubicle, the medical student appeared at the door, to peer round it with elephantine coyness, ‘I’m looking for Sister Brett!’ he chirped, in a falsetto voice. ‘Santa Clause wants Sister Brett –’ and then, as he saw the tableau of now weeping father, angry Gregory, and desperately working Harriet, he dropped his voice and said quickly, ‘Need any help?’

  ‘Yes,’ Gregory said roughly, ‘Take over here, while we get a heart jab organised – jump to it, man!’

  The medical student pulled his frizzy blonde wig from his head, and ran over to the cot, to take Harriet’s place at artificial respiration, and she moved away gratefully, already feeling the strain in her shoulders and back from the even movements she had been making. Still the child didn’t breathe alone, and the medical student, his frilly tu-tu spread absurdly over the sheets, his face, under its comic plastering of make-up, stern and worried, moved his heavy shoulders gently as he tried to pump air into the still body.

  Harriet’s fingers shook as she prepared the special syringe in the sterilising room, fixing the long needle in place on the barrel, handing it to Gregory to draw up the colourless stimulant from the small ampoule he had brought from the poison cupboard. ‘Don’t let her die – don’t let her die,’ she prayed silently, as together they hurried back to the cubicle. ‘Don’t let her die –�
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  Gregory pushed the medical student away from the cot side, as Harriet quickly replaced the mask from the single oxygen cylinder over the blue face, and then held the shoulders straight for Gregory.

  With an unusual tact for a medical student the boy in the tu-tu put a friendly arm across the shoulders of the man standing weeping helplessly against the wall, and tried to lead him out, but the man refused to go, holding on to the cot head with one desperate hand, watching Gregory’s fingers as he ran his fingertips over the framework of ribs, seeking the place to make the heart injection.

  They all held their breath, as they watched him, cocooned in a brilliantly lit glass cubicle while the sounds of singing of ‘Jingle Bells’ came discordantly from the ward beyond, and the glass walls rattled slightly as some of the children in the ward began to bounce on the floor in a dance.

  The syringe barrel flashed a little as Gregory found the spot he was seeking, and eased the long needle through the fine skin, deep into the chest. Slowly, his eyes never leaving the child’s face, he pushed the plunger home, while Harriet held the bird-frail wrist seeking eagerly for the leaping of a pulse.

  But it made no difference, Gregory withdrew his needle, and they stayed very still, watching the tiny body with all their will for her to live in their eyes. But she didn’t move, her eyes still half open above the dark green rubber of the mask, the oxygen hissing gently, the respiration bag on the cylinder limp and still.

  Gregory moved at last, and leaned forward to take the mask from the little face with steady fingers. He pulled his stethoscope from his pocket, and began to move the bell across the still chest, his eyes abstracted as he listened for signs of life. Then he pulled the earpieces away from his head and stood up.

  ‘I’m sorry,’ he said to the man, with a brusqueness born of distress. ‘Sorry. Nothing we can do. We did our best. I’m sorry.’

  The man stared at him with uncomprehending eyes, as Harriet and the medical student stood in helpless pity. ‘My Anna?’ he said huskily. ‘You make her well? My Anna? She well soon?’

  Harriet moved, walked round the cot to put her hands on his shoulders.

  ‘I’m sorry,’ she said softly. ‘So sorry, my dear. But she is dead. We did all we could –’

  ‘No! No –’ The man pulled away from her, his eyes blazing with sudden anger. ‘No –’ and he bent to the bed, to pick up the frail body, clutching her close, shaking her, shouting at her in Greek as he tried to make her move, breathe again.

  Gregory, with a sudden angry shrug, turned away from him, going to the door.

  ‘We aren’t God, man – we aren’t God!’ he said, his voice loud and harsh. ‘We did all we could – all we could – for Christ’s sake –’ And then, he came back, his eyes deep and shadowed in his face, to take the dead child from her weeping father.

  ‘Come,’ he said, laying the child down again on the cot, leaving Harriet to gently pull a sheet up across her small still face. ‘Come –’ And he led the man from the cubicle.

  Harriet watched them walk through the ward, past the children and laughing parents, all of whom seemed unaware of any crisis going on, saw the man stumble as the little boy with the bandaged head chased his frisking puppy across the ward, saw them go into her office. There was some brandy there, and she could see Gregory pour a drink out for the man who slumped in the chair and stared out at the noisy ward with blank eyes.

  The medical student said with a rough voice that barely disguised the tears that were hovering very near the surface. ‘Why? Why do kids have to die? Bad enough when old men do – but why kids? I’ll never do paediatrics when I qualify – so help me God, I won’t –’

  Harriet, with a steady movement that belied her own distress began to pull the curtains around the glass walls, ready for the last task of preparing the child to be removed to the mortuary.

  ‘That’s stupid,’ she said huskily. ‘Stupid. Of course we all feel like that when a child dies – it’s tragic waste, bitterly hurtful. But not so long ago, a death like this was commonplace. Children died of pneumonia all the time. But because people who were distressed by their deaths went on caring about children, trying to find ways to stop such deaths, tragedies like this are rare now. That’s why it hurts more, in a way. When it was common, doctors – people – everyone really, even parents, took it for granted – it was one of those things. When it happens now, we feel – lost, diminished. If you are really upset as you seem, then you will go on to do paediatrics. There’s more to caring about children than providing fun –’ she looked into the ward again before drawing the last curtain, at the happy faces, the laughing parents, the warm gay busy safety of it all, and with a crisp rattle of curtain rings, shut the sight out, and turned back to the boy standing in ridiculous finery behind her. ‘And do you know what you’re going to do now?’ she said to him, putting a hand over one of his cold ones. ‘You’re going to put that absurd wig on again, and you are going to go out into that ward and giggle and caper for all you’re worth. Those children and parents there – they don’t have to be punished because of your sense of inadequacy, because one child slipped through our fingers. We aren’t God – Dr Weston was right – we aren’t, and we have no right to make others suffer because we don’t always manage to be like gods, and save lives. So go and make those children laugh – go on, now.’

  He stared at her, his face angry for a moment, as though he would argue. Then he managed a small grin, and nodded, reaching for his frizzy wig to thrust it over his own crew cut head.

  ‘OK, Sister. Thanks a lot,’ he said, and went. She followed him, and watched as he took a deep breath before leaping into the ward with a squeal, sending the children into renewed gales of mocking laughter.

  And then, she too, pulling her stiff face into a semblance of a smile, followed him out, to make her way through the ward to the kitchen, to see that the children’s special Christmas Tea was ready.

  As she passed the office, Gregory and the man came out, Gregory’s arm over his shoulders, and she took his other hand, and led him to the door.

  ‘So sorry,’ she said, looking into the face now blank and limp with reaction. ‘So sad’ – and the man looked at her, and nodded heavily.

  ‘I’ll drive him home,’ Gregory said crisply, and Harriet saw them both into the lift, watching the cage rattle downwards with a sense of despair that she knew would remain with her for a long time, as it always did after those rare occasions when a child died.

  As she went back to the kitchen, to check on the teas, and then later, as she went back to the cubicle, alone, to look after the last offices for the dead baby, she thought confusedly about Gregory. This episode had somehow increased his stature in her eyes. He had none of the obvious, almost facile, distress that the medical student had shown, a distress that showed itself in a tendency to want to run away from such happenings. His pity was real, real enough in spite of his brusque speech and unsmiling face, showing itself in care for the bereaved father, in providing a drink, and making sure the man got home. And that, she told herself, as she looked down at the body of the child when she had finished her job, that was the essence of working in a hospital. You did what you could for each patient, and when you had done that, you turned to care for someone else. And as she later settled the exhausted and over-excited children in their beds for the night, and tidied away the drift of paper wrappings from parcels, the already broken toys, the mess of fallen pine needles from the Christmas tree, she said a confused prayer for the dead child, mixed up with a sort of thanksgiving for being able to find other people to help, even though the help she had offered to Anna had been useless.

  Chapter Six

  The year drifted gently on its inevitable way, the hospital reflecting the changes of season that happened in the world outside its self-contained life. The pneumonias of the winter months gave way to the increased surgical lists of children who had been waiting for beds to have their operations, and Harriet was busy all day with the rush of adm
issions, preparations, post-surgical nursing and discharges and the increased activity brought with it.

  As spring slowly and reluctantly made way for the warmth of summer, the balcony outside the ward echoed with the shouts of those children well enough to be up and playing about, and the sunshine lit the ward itself into bright patches of light that showed the shabbiness of the old paintwork all too clearly.

  But Harriet hardly noticed the passage of time, so thoroughly had she managed to convince herself of the need to live only a day at a time. Her mind refused, now, to think of the future. Each day was sufficient to itself, each day with its work, each evening with Gregory.

  And as their relationship ripened, as she came gradually to know him more and more, so she came to respect and lean on his judgement. He still never offered any information about himself, never made any mention of his family if he had one, never talked of any part of his life before he had come to the Royal, and Harriet resolutely never asked him, never questioned his past even remotely. She never even asked him if he had been to a particular restaurant before, if he took her to a new one, meticulously avoiding any line of conversation that might lead logically to reminiscence.

  Sometimes, in the deep of the night when she couldn’t sleep, when her pillow knotted itself into hard lumps under her restless head, some of her fears would surge upwards, some of her distress about his lack of demonstrativeness would lift its head, and resolutely, she would push it down again. For he still made no attempt to touch her, except in the most impersonal way, handing her into the car, helping her into her coat so that their hands brushed against each other in what was, for Harriet, an electric moment. Yet despite this, she knew that he loved her, knew that he wanted to touch her, to hold her, to kiss her as much as she wanted to respond. She was always aware of the iron control he exercised over himself, the strength of his intention to avoid the physical contact she knew they both needed so much.