A thin female child of about five opened the door.
'I'm the doctor,' I announced.
The arrival of the obstetrician in such a briskly multiplying area caused no more stir than the visit of the milkman.
'Upstairs, mate,' she said and scuttled away into the darkness like a rat.
The house breathed the sweet stench of bed-bugs; inside it was dark, wet, and rotting. I fumbled my way to the stairs and creaked upwards. On the second floor a door opened a foot, a face peered through, and as the shaft of light caught me it was slammed shut. It was on the fifth and top floor that the accouchement seemed to be taking place, as there was noise and light coming from under one of the doors. I pushed it open and lumbered in.
'Don't worry!' I said. 'I have come.'
I took a look round the room. It wasn't small, but a lot was going on in it. In the centre, three or four children were fighting on the pockmarked linoleum for possession of their plaything, a piece of boxwood with a nail through it. A fat woman was unconcernedly making a cup of tea on a gas-ring in one corner, and in the other a girl of about seventeen with long yellow hair was reading last Sunday's _News of the World._ A cat, sympathetic to the excited atmosphere, leapt hysterically among the children. Behind the door was a bed beside which was grandma-who always appears on these occasions, irrespective of the social standing of the participants. Grandma was giving encouragement tempered with warning to the mother, a thin, pale, fragile woman on the bed, and it was obvious that the affair had advanced alarmingly. A tightly-packed fire roared in the grate and above the mantelpiece Field-Marshal Montgomery, of all people, looked at the scene quizzically.
'Her time is near, doctor,' said grandma with satisfaction.
'You have no need to worry any longer, missus,' I said brightly.
I dropped the kit on the floor and removed my duffle coat, which wept dirty streams on to the lino. The first step was to get elbow room and clear out the non-playing members of the team.
'Who are you?' I asked the woman making tea.
'From next door,' she replied. 'I thought she'd like a cup of tea, poor thing.'
'I want some hot water,' I said sternly. 'Lots of hot water. Fill basins with it. Or anything you like. Now you all go off and make me some hot water. Take the children as well. Isn't it past their bedtime?'
'They sleep in 'ere, doctor,' said grandma.
'Oh. Well-they can give you a hand. And take the cat with you. Come on-all of you. Lots of water, now.'
They left unwillingly, in disappointment. They liked their entertainment to be fundamental.
'Now, mother,' I started, when we were alone. A thought struck me-hard, in the pit of the stomach. The midwife-the cool, practised, confident midwife. Where was she? To-night-this memorable night to the two of us in the room-what had happened to her? Snowbound, of course. I felt like an actor who had forgotten his lines and finds the prompter has gone out for a drink.
'Mother,' I said earnestly. 'How many children have you?'
'Five, doctor,' she groaned.
Well, that was something. At least one of us knew a bit about it.
She began a frightening increase in activity.
'I think it's coming, doctor!' she gasped, between pains. I grasped her hand vigorously.
'You'll be right as rain in a minute,' I said, as confidently as possible. 'Leave it to me.'
'I feel sick,' she cried miserably.
'So do I,' I said.
I wondered what on earth I was going to do.
There was, however, one standby that I had thoughtfully taken the trouble to carry. I turned into the corner furthest away from the mother and looked as if I was waiting confidently for the precise time to intervene. Out of my hip pocket I drew a small but valuable volume in a limp red cover-_The Student's Friend in Obstetrical Difficulties._ It was written by a hard-headed obstetrician on the staff of a Scottish hospital who was under no illusions about what the students would find difficult. It started off with 'The Normal Delivery.' The text was written without argument, directly, in short numbered paragraphs, like a cookery book. I glanced at the first page.
'Sterility,' it said. 'The student must try to achieve sterile surroundings for the delivery, and scrub-up himself as for a surgical operation. Newspapers may be used if sterile towels are unobtainable, as they are often bacteria-free.'
Newspaper, that was it! There was a pile of them in the corner, and I scattered the sheets over the floor and the bed. This was a common practice in the district, and if he knew how many babies were born yearly straight on to the _Daily Herald_ Mr. Percy Cudlip would be most surprised.
There was a knock on the door, and grandma passed through an enamel bowl of boiling water.
'Is it come yet, doctor?' she asked.
'Almost,' I told her. 'I shall need lots more water.'
I put the bowl down on the table, took some soap and a brush from the bag, and started scrubbing.
'Oh, doctor, doctor…!' cried the mother.
'Don't get alarmed,' I said airily.
'It's coming, doctor!'
I scrubbed furiously. The mother groaned. Grandma shouted through the door she had more hot water. I shouted back at her to keep out. The cat, which had not been removed as ordered, jumped in the middle of the newspaper and started tearing at it with its claws.
Suddenly I became aware of a new note in the mother's cries-a higher, wailing, muffled squeal. I dropped the soap and tore back the bedclothes.
***
The baby was washed and tucked up in one of the drawers from the wardrobe, which did a turn of duty as a cot about once a year. The mother was delighted and said she had never had such a comfortable delivery. The spectators were readmitted, and cooed over the infant. There were cups of tea all round. I had the best one, with sugar in it. I felt the name of the medical profession never stood higher.
'Do you do a lot of babies, doctor?' asked the mother.
'Hundreds,' I said. 'Every day.'
'What's your name, doctor, if you don't mind?' she said.
I told her.
'I'll call 'im after you. I always call them after the doctor or the nurse, according.'
I beamed and bowed graciously. I was genuinely proud of the child. It was my first baby, born through my own skill and care. I had already forgotten in the flattering atmosphere that my single manoeuvre in effecting the delivery was pulling back the eiderdown.
Packing the instruments up, I climbed into my soggy duffle coat and, all smiles, withdrew. At the front door I found to my contentment that the snow had stopped and the roads shone attractively in the lamplight. I began to whistle as I walked away. At that moment the midwife turned the corner on her bicycle.
'Sorry, old chap,' she said, as she drew up. 'I was snowed under. Have you been in?'
'In! It's all over.'
'Did you have any trouble?' she asked dubiously.
'Trouble!' I said with contempt. 'Not a bit of it! It went splendidly.'
'I suppose you remembered to remove the afterbirth?'
'Of course.'
'Well, I might as well go home then. How much did it weigh?'.
'Nine pounds on the kitchen scales.'
'You students are terrible liars.'
I walked back to the hospital over the slush as if it were a thick pile carpet. The time was getting on. A hot bath, I thought, then a good breakfast…and a day's work already behind me. I glowed in anticipation as I suddenly became aware that I was extremely hungry.
At the hospital gate the porter jumped up from his seat.
''Urry up, sir,' he said, 'and you'll just make it.'
'What's all this?' I asked with alarm.
'Another case, sir. Been waiting two hours. The other gentlemen are out already.'
'But what about my breakfast?'
'Sorry, sir. Not allowed to go to meals if there's a case. Orders of the Dean.'
'Oh, hell!' I said. I took the grubby slip of paper bearing another address. '
So this is midwifery,' I added gloomily.
'That's right, sir,' said the porter cheerfully. 'It gets 'em all down in the end.'
10
Everyone working in hospital is so preoccupied with the day-to-day rush of minor crises that the approach of Christmas through the long, dark, bronchitic weeks of midwinter comes as a surprise. The holiday cuts brightly into hospital routine, like an unexpected ray of sunlight in an Inner Circle tunnel. At St. Swithin's there was, however, one prodromal sign of the approaching season-a brisk increase in attendance at the children's department.
Every year at Christmas the Governors gave a tea-party in the main hall of the hospital for a thousand or so of the local boys and girls. They were men not used to stinting their hospitality, and provided richly for the tastes of their guests. It was the sort of affair that could be adequately described only by Ernest Hemingway, Negley Farson, or some other writer with a gift of extracting a forceful attractiveness from descriptions of active animals feeding in large numbers.
The children began to collect outside the locked doors of the out-patient department soon after midday; by three the front of the hospital looked like an Odeon on Saturday morning. At four sharp the doors were opened by the porters and the mob were funnelled into the building-scratching, fighting, shouting, and screaming, their incidental distractions from the fists and elbows of their neighbours overwhelmed with the urgent common desire to get at the food. They rushed through the entrance lobby, stormed the broad, wooden-floored hall, and expended their momentum in a pile of sticky, white-glazed buns.
The buns were the foundation of the party, but there was a great deal more besides-a high Christmas cake flaming with candles, churns of strawberry ice-cream, jellies the colours of traffic lights, oranges with a tenacious aroma, and sweet tea in long enamelled jugs. The non-edible attractions included paper chains, crackers, funny hats, a tree ten feet high, and Father Christmas. It was the duty of the children's house-physician to play this part. The gown, whiskers, sack, and toys were provided by the Governors; all the doctor had to do was allow himself to be lowered in a fire-escape apparatus from the roof into the tight mob of children screaming below. This obligation he discharged with the feelings of a nervous martyr being dropped into the bear-pit.
It was inevitable that he should breathe heavily on his little patients a strong smell of mixed liquors, which never missed their sharp, experienced noses and gave rise to delighted comments:
'Coo! 'Ees bin boozing!'
'Smells like Dad on Saturday!'
'Give us a train, Mister!'
All this the house-physician had to endure with a set smile of determined benevolence.
The party was controlled, where possible, by the outpatient sister and a reinforced staff of nurses. Their starched caps and aprons melted in the afternoon with the ice-cream as they attempted to impose the principle of fair shares on a community demonstrating a vigorous capitalist spirit of grabbing what they could. The energy of the children diminished only if they had to retire to a corner to be sick; but the hospitality of St. Swithin's was unlimited, and it usually happened that several of the little guests were later asked to stay the night.
The reason that the annual tea-party afforded as sure an indication that Christmas was approaching as a polite postman lay in the rules for admission to the jamboree. The Governors had decided many years ago that as it was impossible to entertain every child in the district invitations should be sent only to those who had attended the hospital in the months of November and December. As all the children within several miles knew of the party and were perfectly familiar with the qualifications for entry the increase in juvenile morbidity after October 31st was always alarming. This had recently led an ingenuous new house-physician in the department to sit down and prepare for publication in the Lancet a scientific paper on the startling increase in stomach-ache and growing pains among London school children in the last quarter of the year.
The goings-on at Christmas-time were conducted with the excuse that the staff was obliged to entertain the patients, just as adults take themselves off to circuses and pantomimes on the pretext of amusing the children. The wards were decorated, the out-patient hall spanned with streamers, and on Christmas Day even the operating theatres were festooned. The hospital presented the grotesque appearance of a warship during Navy Week, when the guns and other sinister implements aboard are covered with happy bunting. Relatives, friends, visiting staff, old graduates, and students overran the place; it was an enormous family party.
I had dutifully returned home the first Christmas I was in the hospital, but for the second I decided to stay and join in the fun. I was then coming to the end of my second session of medical clerking, this time as a protйgй of the Dean, Dr. Loftus, on Prudence ward.
A week before Christmas Eve the ward sister distributed sheets of coloured crepe paper round the patients and set them cutting frilly shades for the bed-lamps, paper chains, cut-outs for sticking on the windows, and the other paraphernalia of Christmas. Sister Prudence was different from the majority of her colleagues at St. Swithin's. She was a fat, kindly, jovial woman with an inefficiently concealed affection for Guinness' stout. She never had a bitter word for the students, whom she regarded as pleasantly irresponsible imbeciles, and she treated the nurses as normally fallible human beings. Above all, she had the superb recommendation of hating Sister Virtue's guts.
'I'm so worried about number twelve,' she said to me quietly one afternoon. I followed her glance to a wizened, sallow old man lying flat on his back cutting out a red paper doll with no enthusiasm. 'I do hope he won't die before Christmas,' she continued. 'It would be such a pity for him to miss it all!'
On Christmas Eve the students and nurses tacked up the paper chains and fixed the Christmas tree in front of the sanitary-looking door of the sluice-room. Sister beamed at the volunteers, as she was by then certain her ward would be more richly decorated than Sister Virtue's. It was a vivid jungle in paper. Red and yellow streamers hung in shallow loops across the forbidding ceiling and the dark woodwork of the walls was covered refreshingly with coloured stars, circles, and rosettes, like a dull winter flower-bed in springtime. The severely functional lights over the beds were softened by paper lanterns, which emitted so little light, however, that they transformed even a simple manoeuvre like giving an injection into an uncomfortable and dangerous operation. The black iron bedrails were garlanded with crimson crepe, the long table down the middle of the ward was banked with synthetic snow, and blatantly unsterile holly flourished unrebuked in every corner. Most important of all, a twig of mistletoe hung over the doorway. By hospital custom, to avoid interruption in the daily working of the ward the sprig was not put into use until Christmas morning; before then the nurses and the students took a new and keen appraisal of each other with sidelong glances, each deciding whom they would find themselves next to when the sport opened. As for Sister Prudence, she would have taken it as a personal insult not to be embraced by everyone from Dr. Loftus down to the most junior student. 'I do like Christmas!' she said enthusiastically. 'It's the only time an old body like me ever gets kissed!'
The students had a more exacting task at Christmas than simply decorating the ward. It was a tradition at St. Swithin's that each firm produced, and presented in one of the main wards, a short theatrical entertainment. This was in accordance with the established English custom of dropping the national mantle of self-consciousness at Christmas-time and revealing the horrible likeness of the charade underneath. No one at St. Swithin's would have shirked acting in, or witnessing, the Christmas shows any more than they would have contemplated refusing to operate on an acute appendix. They were part of the hospital history, and it was handed down that Sir Benjamin Bone himself when a student contributed a fine baritone to the Christmas entertainment while the young Larrymore accompanied him on a violin, deliberately out of key.
The dramatic construction of these performances was as rigidly conventional as class
ical Greek drama or provincial pantomime. There were certain things that had to be included, or the audience was left wondering and cheated. It was essential at one point for a large student to appear dressed as a nurse, with two pairs of rugger socks as falsies. There had to be a song containing broad references to the little professional and personal idiosyncrasies of the consultant staff-oddities that they had previously been under the impression passed unnoticed. Equally important were unsubtle jests about bedpans and similar pieces of hospital furniture. One scene had to represent a patient suffering under the attentions of a scrum of doctors and students, and there was always a burst of jolly community singing at the end.
The players had their conventions as well. No troupe would have contemplated for a moment taking the boards sober, and the most important member of the cast was the supernumerary who wheeled round the firkin of beer on a stretcher. It was also essential to carry a spare actor or two in the company, as on most occasions some of the active performers were overcome before the last scenes and had to be carried to the wings.
Two days before Christmas Grimsdyke took the initiative by ordering our firm to assemble in the King George at opening time that evening. There were seven of us: Grimsdyke and Tony Benskin, John Bottle, the middle-aged student Sprogget, Evans, the brilliant Welshman, the keen student Harris, and myself. We collected round the piano in a corner of the bar.
'Now, look here, you fellows,' Grimsdyke began with authority. 'We must scratch up a bit of talent between us. Time's getting short. We've only got a day and a half to write, produce, and rehearse what will be the most magnificent of performances that ever hit St. Swithin's. Can any of you chaps play the piano?'
'I can play a bit,' I said. 'But mostly hymns.'
'That doesn't matter. Those hymn tunes can be turned into anything you like with a bit of ingenuity. That's one thing settled at any rate. What sort of piece shall we do? A panto, or a sort of pierrot show?'
DOCTOR IN THE HOUSE Page 9