Chapter Seven
She realised, quite suddenly, that she was actually enjoying herself. The past twenty minutes had been quite extraordinarily hectic, as together they boiled instruments, broke out the neuro packs – which Adam found in the bottom of the big neuro instrument cupboard (“Be logical, girl,” he’d snapped. “Where the hell else are they likely to be?”) and set gowns, gloves, masks and the rest of the paraphernalia of surgery ready.
In fact, she remembered far more than she realised from her previous Theatre experience, and her hands seemed to take over from her mind as smoothly she made the pattern of a prepared Theatre build up around her busyness. When she asked Adam what he wanted in the way of ties and sutures, and showed him the big tray of atraumatic needles, tubes of assorted catguts and nylon and silk ties she had found on the lowest shelf of the neuro cupboard, he grunted approvingly and said, “Lay out the lot – two of each, to be on the safe side. The most important thing is to be sure the sucker’s going well. That skull isn’t going to be easy to find my way around, I suspect. Right, now. All set? How long have the instruments had?”
She peered up over her mask at the big clock. “Twenty minutes.”
“Right.” He made for the door. “I’ll call the ward to send the patient up, and then I’ll scrub. Then you can dish up the stuff after the patient’s on the table, and I’ll help set the trolley while you scrub – ”
“While I scrub?” she yelped, terrified again. “But wouldn’t it be better if I stayed as dirty nurse? Someone’ll have to run – ”
He shook his head. “No. The ward girl’ll have to do that for us. I’ve got to have someone to assist me, and there’s no one else but you.” He looked back at her from the floor, and smiled fleetingly, his eyes crinkling over his mask. “Don’t worry. You’ve managed very well so far. You can do it.”
I wish I could be so damned sure, she thought frantically, as she made a last check that all was ready. It’s been a hell of a long time since I scrubbed for a theatre case – and even then it was only an appendix, and not a brain – oh, Ngaire, where the hell are you? It’s getting near to one o’clock, and you promised you’d be back at midnight. I feel like Cinderella in reverse or something –
Far away, she heard the rattle and clang of the lift again, and then the big doors swung open, and the trolley came in, pushed by a ward nurse, carrying high in one hand a blood transfusion bottle, and guided by Adam himself. Together, the three of them lifted the heavy patient on to the table under the cruelly revealing bright light and she looked down at the waxen face under the almost as white bandage that covered the skull, and thought confusedly “he looks very young – twenty or so, no more – ”
And then, the ward nurse clipped the blood bottle to the stand at the foot of the table, and checked that the tube that ran into the patient’s ankle was smooth and the blood dripping steadily, and Adam rapidly fastened the broad rubber straps across the flaccid arms and legs.
“There’s no need for an anaesthetic, of course,” he told the ward nurse, who was hovering anxiously beside him. “He’s deeply unconscious, and I don’t want to mask any responses we may get as we relieve the pressure on the brain – but if he gets restless – starts to move – during the operation, watch that drip, OK? No, don’t worry – ” he caught the look of horror in the girl’s eyes. “I know it sounds odd, but this is necessary and it’s normal procedure. He’ll feel no pain, of course. Right, keep a check on his pulse and blood pressure, then, and we’ll be ready to go in – ten minutes,” he looked again at the big clock, then at Tricia. “Very well, Nurse, dish up. I’ll be ready when you are.” And he went swiftly to the scrubbing-up area at the far end of the theatre.
Tricia, sweating a little in the heat and manipulating the big bowl and instrument tray forceps a little stiffly at first, but then with increased assurance, carried the great trays of instruments from the sterilisers to the trolley, then brought out the stacks of bowls and kidney dishes and little gallipots, and distributed the instruments along the towelled surface of the trolley. Drills, hammers, small bone chisels, burr heads. Check. Suction heads, artery clips, retractors. Check. Sponge holders, needle holders, scissors, scalpels. Check. Swabs, packs, lotions, handbowls. Check –
And then Adam called her, and quickly she tied his gown behind his broad back, and flipped an envelope of gloves out of the drum towards him, thinking absurdly – size eight and a half. I knew he had big hands – and then he was sleeking the smooth, soft, brown rubber over his fingers, twisting his gown cuffs deftly under the wrists of the gloves as he moved over to the table
“Scrub fast, Nurse,” he said over his shoulder as he went. “Nurse Thingy here from the ward will tie your gown – ” and Tricia nodded, and kicked the tap control under the basin with her right foot, and as the warm water gushed over her shaking hands, started the methodical scrubbing of fingers, palms, backs of hands, wrists –
Behind her she could hear the heavy breathing of the man on the table, the click and rattle of instruments as Adam set out the instruments in the order he wanted them, the quiet burr of his voice above the rush of water as he told the ward nurse how to connect up the sucker. Then the sucker hissed and bubbled, faltered and then hissed again steadily, and she looked up at the clock, and thought – three more minutes to scrub –
As the ward nurse tied her gown strings behind her, she hissed into Tricia’s ear, “What’s going on here? Why only you? Where’s the usual theatre girl?” but Tricia pretended not to hear, to be too busy putting on her golves. It was crazy to think there wouldn’t be trouble over this; someone in authority was sure to find out that the wrong nurse had been on Theatres tonight, and then, oh boy, would she and Ngaire be in trouble –
But there was no time to think of that now. The important thing was to get the operation over. Safely. And she found herself praying, somewhere deep inside herself, please, let it all be all right, let him get well, don’t let him die – though she knew just how desperately ill the man was, just how slender were his chances. Adam had to find the bleeding point, and find it fast, she realised as she heard again, above the sound of the hissing sucker, the heavy thick breathing, saw the sickly colour of the man’s face as, expertly, Adam picked up forceps with which to take off the bandage that covered the skull.
At least we don’t have to shave the head, she thought, as she clipped a green towel around the forehead, mercifully covering the blank pallid face and rim of white which showed under the relaxed lash-fringed lids. The stitches that had been put in the scalp only this morning were revealed as the last dressing came off, and she picked up a pair of sponge holders and a swab of cotton wool, and dipping it into the gallipot of prepared skin lotion, began to paint the scalp in long smooth strokes.
Beside her, Adam picked up scissors and forceps and his big square fingers, moving with deceptive slowness, began to snip out the stitches, and then the pearly gleam of bone appeared, and she closed her eyes for one sick moment; she had forgotten how momentarily distressing it was, this first assault on a human creature, lying still and helpless on the table. It had always made her feel a stab of pity, made her feel as though it were her own body that was being probed at and touched with those impersonal cold metal instruments.
But the moment passed, and she was too busy to feel anything for the patient, watching those hands, trying to anticipate each move, trying to decide what instrument he’d need next, feeling a surge of triumph when she guessed right, and then the angry self blame that came when she guessed wrong, and he waved away one of her proffered instruments and clicked his fingers irritably towards another.
There was a long agonising pause for her then, as he fitted a fine burr to the small hand drill, and after a moment of apparent indecision, set the delicate curved tip of the instrument against the pinkish grey bone, and began, at first slowly, and then more rapidly, to turn the drill, one hand following the other in perfect rotary movements. And the burr head slid gently inwards, and she co
uld only stand and watch, feeling as though the drill were in her own hands, as though she had to make the hairsbreadth judgement, had to decide when the shell of bone had been just penetrated, to stop before the vulnerable brain tissue was touched.
But the judgement was made for him, for suddenly bright red blood welled up, and he said with a suddenness that made her jump, so loudly did his voice ring out in the hissing silence, “Sucker!”
And she put the long curved sucker end into the hand he held out without looking up, and nodded at the ward nurse, who immediately kicked the switch on the machine on the floor.
The machine bubbled, and the redness slowly shifted from the operation area to the bottle that was clipped to the machine, making its watery contents a rosy translucent and gradually deepening pink.
He reached out his hand again, and automatically, her own picked up the fine Gigli saw – the length of delicate steel wire that was needed to cut the bone connecting the new burr hole to one of those that had been made during the morning’s operation, and again his hands moved in a balletic smoothness as the protective shell of skull gave up its defences, and revealed the beautiful convoluted surface of the brain. And she felt that long-forgotten surge of satisfaction that she had been used to knowing, in the days when she had been a junior theatre nurse, seeing the very real loveliness of a section of the human body that was usually so secretly hidden opened to her watching eyes. There was nothing to fear, nothing to regard as nasty or ugly in any aspect of the body, and she looked and felt humble at what she saw.
The sucker, probing deeper as his smooth, brown-gloved hand guided it on, bubbled faster, and the pink water in the bottle deepened to a glow that threw a dancing ruby reflection on the grey terrazzo of the floor, and he said urgently, “I think I’ve found it – quick. An atraumatic needle – medium size – ”
Again her hands seemed to act of their own volition, selecting from the sutures tray the one he wanted, wrapping the glass tube in a gauze swab, cracking it with a sharp twist of her wrists, pulling out the tiny hank of catgut twisted round the filament of gleaming steel needle, and fastening it to the needle holder with a click of the handles as the ratchets met and held.
As she put it into his waiting hand, the sucker sang and bubbled less loudly, and there was a movement beneath the green sheeting that covered the man on the table, and the ward nurse cried shrilly, “He’s moving – Dr Kidd – his legs moved!”
“Good – good – then I have got it – ” Adam said, and there was jubilation in his voice. “Watch that bloody drip – he’ll move more yet – ”
Across the big theatre she felt rather than saw the door open, but she didn’t look up, too busy preparing another atraumatic needle, knowing he’d need it. When she was ready, and holding it out towards him, she saw the ward nurse scuttle to one side with alacrity, saw her place taken by another, small figure. And looked at the face of the newcomer, and saw above the line of the mask across the nose the wide eyes of Ngaire, and she grinned in sheer relief.
But Ngaire just looked back at her, her eyes showing no response, but Tricia forgot her as Adam put his hand out again, and she took the spent needle from him, and gave him the new one, and he grunted, and jerked his head towards the sucker which he was holding in his other hand.
“Here – keep the suction going – just there. No deeper, or God help you. I’ve got to get a retractor in – ”
As they worked on, the movements of the man on the table increased, and Ngaire called softly to the ward nurse. “Here! Hold his legs. I’ll take the arms – ” and together the two gowned figures held desperately on as Adam, his hands now moving so swiftly Tricia could hardly keep up with his demands, completed his manoeuvres with the needle and catgut, tied the ends, snipped away the needle with the scissors, and very gently, pulled the sucker head from Tricia’s hand, and eased it slowly out of the wound.
Then, they all stood still, only the patient moving with an occasional spasmodic heave, watching the operation area. But no more frightening redness welled up, no more did the bottle deepen its ruby glow, and the reflection on the floor stopped moving as no more liquid from the skull came down the tube to join the bottle’s contents.
“Right.” Adam’s voice sounded very matter of fact, and again Tricia jumped slightly at the sound. “I’d say we’ve got it. Nurse – er – Thingy.”
He looked up, and for the first time became aware of the fact that there were two figures beside the patient, and his eyebrows lifted, and he said, “Oh – Nurse Taylor? Good. You’ve finished that case in general theatres? Everything all right?”
Ngaire stared at him, and her brows too moved under the edge of her cap, and Adam went on smoothly, “Well, we’re almost through here. Check his blood pressure, will you? And then I want you to give him the drugs he needs – you’ll find them ready on the side by the gloves. I put them there before we started – hurry along, now. You can inject straight into the drip tube.”
Tricia could have wept with gratitude as she realised just what he had done. To have covered up for them both, in front of another nurse, was incredibly good natured of him, she told herself as she prepared the skin sutures, and put the needle holder into his waiting hand. He could have raised merry hell in the office for this evening’s escapade, but instead – really, a generous bloke. How could she have thought him so disagreeable all these weeks?
And then, suddenly, it was all over. The skin sutures were in the scalp, a row of tidy little knots, and together she and Adam managed to get a firm dressing on, although it wasn’t easy, for now the man, albeit still unconscious, was moving considerably, thrashing about heavily so that it took all the muscle power they had between them to hold him still. But they managed it, and then Ngaire was there beside the table with the trolley ready to take him back to the ward, and Tricia hadn’t even realised she’d gone out to get it.
The four of them heaved the man on to the trolley and wrapped the red blankets carefully across him, strapping it in place with the wide leather trolley straps, and then the ward nurse, again holding the blood bottle high in the air, was moving backwards out of the theatre, while Adam was at the head holding the man’s chin up firmly with one hand, the other on the brilliant white bandage and looking hugely protective there.
The double doors swung behind them, and once again there came from the distance the crash of the lift gates, the faint whining hum as it moved away towards the First Floor, and the two girls stood silent in the shambles that the theatre had become. Looking down at her gown. Tricia realised for the first time that it was heavily bloodstained, that even the floor was spattered, that the trolley of instruments was an incredible mess of discarded towels and swabs and used instruments
She looked up, and shakily pulled the gloves from her fingers, to drop them into the bowl of water that stood in a rack beside the table, and then she pulled her mask down till it dangled below her chin, and said sardonically to Ngaire, “Well, hello there. So what kept you? I suppose you realise what you’ve done, you bloody idiot? And that he covered up for you in front of that girl from the ward? Where were you, for God’s sake? Do you realise what the time is?”
Ngaire too had pulled her mask down, and stood looking at Tricia with her face suffused with misery. “Oh, Trish – I – you can’t – if I tried to tell you, I’d – ” and then her eyes filled with tears, till they spilled over and ran down her face, and she was gulping and sobbing, holding her hands one on each side of her face as though she knew no other way to hold her shaking head still.
But Tricia was in too towering a rage to respond as she would normally have done to so pitiful a sight. “So I should think, you fool! God alone knows whether we’re going to get away with this. If we don’t, it’ll be your fault and no one else’s – do you think that – ”
“Well, I hardly see that shouting at her like a fishwife is going to do much good. It would be a little more to the point to use some of the excess energy you seem to be blessed with in clea
ring this place, wouldn’t you say?”
Adam Kidd was standing by the door, both hands behind his neck as he fiddled with the ties on his gown, and then impatiently he tugged until the narrow tapes broke and he pulled off the gown to throw it over the operating table.
“If anyone has cause to be angry, it’s me, I would say. More by luck than anything else, it’s gone all right. The man should make it because I found the slipped tie easily. What would have happened if I hadn’t I don’t like to think of. Now, Nurse Taylor – stop that ridiculous noise at once, and blow your nose. And then you can get this place organised and go off duty – ”
“I – I’m sorry, Dr Kidd,” Ngaire managed to say, and then took a deep breath, and digging into her pocket for a handkerchief, blew her nose violently. “I appreciate very much the way you – I mean, that about being on general theatres. You didn’t have to cover up for me, and I truly – ”
“Cover up for you?” He raised his eyebrows at that. “You don’t think I gave a damn about you, do you?” he flicked his eyes towards Tricia then. “About either of you for that matter, though you did very well, Nurse Oxford, under the circumstances – better than I’d suspected you could, but only as well as you should have done, since you agreed to get yourself into such a situation that the ability to cope was demanded of you. No, my dear young ladies – ” and the sneer in his voice was very apparent, “My covering up for you, as you put it, was sheer enlightened self-interest. If you think, either of you, that I have the time or the inclination to get myself involved in a great boring argument involving the nursing discipline of this hospital, that I’m prepared to waste my energy talking about this evening to your Matron and the rest of them, you have another think coming. I couldn’t care less about what rules you’ve broken, or what would happen to you if your breaking of them was discovered. The operation went reasonably well, and that’s all I’m concerned about. And if you’ve any sense at all, you’ll both keep your mouths shut about it. Now, goodnight. You’d better get to bed, Nurse Oxford, and leave your colleague to clean up, since you will be on duty on my floor first thing in the morning, and I want to be sure you’re in a fit state to work. And Nurse Taylor will have the excuse of having dealt with a night case, so she’ll be allowed to catch up on her rest, I imagine.”
The Private Wing Page 9