Visiting Consultant

by Neels, Betty

  Despite the fact that Sophy went to church, cooked the Sunday dinner, took the Blot for a long walk which neither of them really enjoyed, and wrote a number of unnecessary letters, she had far too much time to think about Max. The family had listened enthralled to her account of the previous evening’s der lights, but she could not talk about them to the exclusion of everything else.

  She was glad when it was Monday again. There was a long, exacting list in theatre; probably Max would have nothing to say to her beyond a civil good morning, but at least she would see him. She almost ran to the hospital in her anxiety to be under the same roof as he was, quite forgetful of her resolve not to see more of him than was necessary for their work. But this didn’t matter, anyway; Max was friendly and pleasant, but evinced no desire for her company. Indeed, he spent several hours with Penny and Benjamin and Grandmother Greenslade, and stayed to tea, on the one day in the week when she was on duty from eleven until eight in the evening. She told herself that she didn’t mind in the least, and was very careful, when she saw him next, to let him see that she hadn’t minded at all.

  Sunday came round once more. Staff had the weekend off, so had Winters. That left Vincent, the third-year nurse, and Robins, and both theatre porters on duty. It seemed a crowd, but one of the porters and Vincent had half days. The day passed uneventfully and she filled it with the hundred and one small jobs which had accumulated during the week. Tom Car-ruthers came up and they went over the next week’s list together while they had their coffee, and he had then gone away again to read the Sunday papers. It was about five o’clock when two RTAs arrived together, and Sophy, answering a cry for help from Cas sent the remaining porter down to help out. Robins was painstakingly folding masks, and Sophy went back to her lists and requisitions, to be interrupted shortly by Tom on the telephone.

  ‘We’ve got six nasty ones down here. We’ll have to do one as soon as we can get some blood into him. Can you manage forty minutes, Sophy? Pelvic crush and very dicey.’ He didn’t wait for an answer, for he knew that Sophy would be ready—she always was. ‘Sophy? Can you spare your man for a bit longer? It’s all hell let loose down here.’ Sophy said Yes, for there was nothing else to say, and hung up, and went into the theatre. She looked at Robins and wished fleetingly that she had someone else on duty, then dismissed the thought as a waste of time. Robins was still slow and nervous, but she knew the routine now, and Sophy set her to work, while she herself put up the Lloyd-Davies crutches and the stirrups—the patient would almost certainly be put in Trendelenberg-lithotomy position. She put the extra instruments they would need into the second autoclave, and presently, gowned and masked and gloved, she laid up the theatre, her small sterile person whisking around with methodical, precise speed.

  She was arranging knives and forceps on the Mayo’s table when she heard the gentle swish of the trolley’s rubber tyres, and then the murmur of voices from the anaesthetic room. Her sharp ears heard the sound of running water in the scrub room too, and she nodded to Robins to go there, ready to tie the gowns as the surgeons were ready.

  She was taken by surprise when Max sauntered in and took up a position well away from the table, where they were busy arranging the patient. Her heart bounced against her ribs, and her voice, in answer to his civil good evening, was a shaky squeak. But by the time the two men were standing each side of the patient she had command of herself once more, and was able to reply in her usual pleasant, level voice when Max looked around the theatre and asked if the nurses had gone on strike.

  ‘It’s Sunday, sir,’ she said sapiently, ‘so only two nurses on after six o’clock. I’ve a porter too, but he’s gone back to Cas to help out.’ As she stopped speaking, an ambulance, its see-saw warning blaring urgently, went past in the street below.

  Max dropped some discarded Spencer-Wells forceps on to the Mayo table. ‘It sounds as though he will be very welcome there.’ He shot a look across the theatre at Nurse Robins, whose eyes were glued on Sophy; her anxiety not to miss anything gave her the air of a long-distance runner the second before the starting pistol goes off. Sophy knew exactly what he was thinking, and said stoutly,

  ‘Nurse Robins and I can manage perfectly well, sir.’

  He had made a right paramedian incision, and he and Bill were busy tying off; he said crisply, without looking up, ‘I have no doubt of that, Sister.’

  They worked in silence for some time until Max said, ‘Now let us assess the damage...’

  The list was a formidable one involving a great deal of cutting out and patching up and sewing and stitching together.

  ‘I’m surprised,’ Max said, ‘that an iron girder left us anything to work on.’ He went on briskly. ‘Right nephrectomy—I’ll do it through this incision—repair of liver; suture of bladder, splenectomy and resection of gut. All right, Sister?’

  ‘Quite all right, sir.’

  Her voice sounded very faintly smug as she took a sterile towel from the end of one of trolleys, revealing all the extra instruments he would be likely to use. He took her foresight for granted, however, and she felt keen disappointment, instantly swallowed up by the necessity of paying close attention to her work.

  An hour, an hour and a half went by unnoticed, while the crushed body on the table was slowly and methodically set to rights. Mostly there was a relaxed silence, broken from time to time by casual conversation. Sophy noted with satisfaction that the tension had gone out of Nurse Robins; due to the Dutchman, who had gone out of his way to joke gently with her and put her at her ease. Sophy eased her weight from one neatly shod foot to the other and then stiffened suddenly as the quiet of the theatre was shattered by the banshee wail of the fire alarm. Max took no notice of it whatever, and Bill, after a glance at his chief, ignored it too. Dr Walters twiddled a knob or two on the Boyle’s machine and muttered, ‘That’s all we need.’

  The alarm went on and on, searing the eardrums of its hearers. When it at length stopped, Max asked, ‘Fire, Sister?’ He didn’t look up from his sewing.

  Sophy, who was beginning to wonder if he had heard the hellish noise, put a Paul’s tube and a glass rod on to the Mayo’s table, and said dryly. ‘I imagine so, sir. Nurse shall find out.’

  She arched her eyebrows at Robins, who hurried over to her, missing the surgeon by such a narrow margin that Sophy’s quick, indrawn breath sounded loud in the silence. She spoke in her usual measured tones, however, and Robins with an apprehensive glance at Max, slipped away.

  He said, without looking up, ‘Never mind, Sister. A miss is as good as a mile.’

  She was saved from replying by the thunderous din of the fire engines taking the corner below in an accumulation of sound that made speech a useless thing. Robins, returning precipitately, had to wait, standing in an anguished silence until the last of them had wailed to a halt.

  ‘Pratt says there’s been an explosion in Edward— it’s being evacuated, some patients and nurses are hurt. Alexander is being evacuated too—and Cas.’

  Sophy stared at her, blinked, and said, ‘Thank you, Nurse. We had better check swabs, hadn’t we?’

  She watched Robins start, then turned and started her own count. It didn’t take her long; she stood patiently, waiting for the nurse to finish, her thoughts racing. The theatre suite was the corner stone between Centre Block and Edward and Alexander Cas was directly below. A door at the end of the theatre led to a landing containing a staircase and lift, which gave access to the wards and Casualty. She glanced instinctively towards the door—it was a nice solid one, she noticed with satisfaction, and there was the landing between...

  Another fire engine sped past, and above its diminishing noise she heard the telephone ringing. Robins disappeared for a second time, and Sophy picked up a probe with her Cheatles and put it unerringly into the gloved hand hovering in front of her. Mechanically she gave Bill more swabs, rinsed a few instruments; took the loop off the diathermy handle and substituted a disc in obedience to Max’s quiet order. The operation was goin
g very well, but was by no means over. There was a good deal of noise by now, but it was muffled and she had neither the time nor the inclination to interpret it. Robins came back, almost running. Sophy said steadily in a warning voice, ‘Don’t come any nearer the table, Nurse, and please give us your message.’ She watched the girl pull herself together, and said, ‘Good girl! We’re quite safe here, you know, for a long while yet.’ She wished she could believe herself, but she sounded convincing, anyway.

  ‘That was Matron, Sister. She says could Mr van Oosterwelde arrange to evacuate the theatre within ten minutes. They’re trying to hold the fire in check, but the wind is blowing towards us...’ She stopped, then said rather wildly, ‘Oh, Sister, whatever shall we do?’

  Sophy, resisting a desire to pass the question on to Max van Oosterwelde, said bracingly, ‘Was that all the message, Nurse?’

  Robins gulped. ‘Matron asked if you needed help, because if you could manage she would be glad, as there isn’t anyone to spare at the moment. And would you send the patient to George; they’ve turned one of their bathrooms into an intensive care unit.’

  Sophy was amazed to hear Max laugh, and after a moment the other two men joined in. Evidently they saw humour in the situation; she frowned blackly at Bill, who stopped laughing long enough to explain that the idea of wheeling the patient in his present very unfinished state into one of old Mother Forbes’ spotless bathrooms was just about the funniest thing that had happened for weeks. Sophy had to smile a little at that; Sister Forbes had a passion for an apple-pie order—she must be suffering acutely from an influx of patients who weren’t hers and were probably too scared to care if they were disorganising her tidy ward.

  Having deliberately eased the tension around him, Max said coolly, ‘Telephone Matron and give her this message, please, Nurse. I regret that the theatre cannot be cleared for another hour; perhaps a little less than that. I should suggest that a couple of firemen come up and clear the anaesthetic room, don’t you agree, Sister?’

  Sophy wiped the stitch scissors carefully. ‘A very good idea, sir,’ she said cheerfully. At the moment at any rate, she found herself quite unable to feel even faintly frightened; she trusted Max completely, she had no need to worry.

  Robins went away again, and Sophy took the opportunity to ask if it wouldn’t be a good idea for the girl to stay in the anaesthetic room and help the firemen. ‘Then they won’t overlook anything,’ she explained carefully, ‘and it will keep Nurse busy.’

  ‘Can you manage on your own?’

  ‘Oh, yes. Nurse can stock me up before she goes, and I’ve got everything here that you could possibly need.’

  He shot her a sharp glance. ‘Very well, if that suits you, Sister.’

  Nothing much happened—there was noise, naturally, but it seemed subdued and far away. Robins returned, did as she was bid, and disappeared yet again. They could hear subdued voices and the sounds made by people in a hurry trying to be quiet, coming from the anaesthetic room. A small pool of water had formed inside the door leading to Edward wing; obviously the firemen were somewhere, probably on the landing, using their hoses. Sophy still felt quite safe. When Robins came back, they checked swabs again before she set her to renew all the lotion bowls. The powerful lamp over the table went out without so much as a flicker to warn them. Max said something explosive as Sophy said, ‘Emergency lights, Nurse. As quick as you can.’ It was only seconds before they had light again, albeit one that had to be manoeuvred into exactly the right position. Sophy sent up a little prayer of thankfulness that she had had it overhauled within the last day or so. She tidied the Mayo’s table, gave Bill some forceps and a further supply of swabs, then looked automatically around the theatre. The pool by the door had increased she noted, and blinked and looked again. A little wreath of smoke, dainty as grey chiffon was oozing round the door. Robins saw it too, and said before she could stop herself, ‘Sister, the smoke’s coming in.’

  Sophy, forced to a normality she was no longer feeling observed, ‘Yes, Nurse, so I see. There’s bound to be a few stray wisps...the wind, you know.’

  As if to give the lie to this erroneous remark, a framework of feathery black smoke erupted around the door, pushed from behind by some giant force. Sophy felt a prickle of sweat on her forehead, while icy fingers played a scale down her spine. With hands that shook only very slightly she wrung out several towels in water and piled them neatly where she could snatch them up at speed, then gave a very wet one to Robins with instructions to dampen the surgeons’ masks and then Dr Walker’s, and to take a second one with her Cheatles and lay it close to the patient’s face. The smoky frame doubled its size and a little of it eddied away from the door. Max van Oosterwelde straightened up from his stitching, put his discarded needle holder down, and took the length of gut Sophy was holding out between rigidly held hands. He said quietly,

  ‘You and Nurse go now, Sister, we can manage very nicely now, I think.’

  Sophy nodded to Robins, who came near enough to whisper, ‘You’ll come too, Sister?’

  Sophy didn’t answer her question, but said softly, so that Max wouldn’t be able to hear, ‘Report to Matron if you can find her—if not, anyone who ought to know—police or firemen or someone like that—then go to George and tell Sister you’ve come to help until we bring the patient.’ She winked cheerfully and cocked her head towards the door. Robins rather uncertainly winked back, and slid quietly away.

  Sophy threaded two needles; she thought she had better do them while her hands were still under her control. She jumped visibly when Max said gently. ‘You too, Sister. I’m sure Bill can thread needles, and I believe that I am still capable of picking up any instruments I may need.’

  The theatre was suddenly filled with sound—a long-drawn-out, slow-motion noise of bricks and girders and glass tumbling lazily. Max tied an artery and Bill took off the forceps neatly, remarking cheerfully, ‘Something’s fallen down.’

  ‘Edward’s roof,’ said Max, and tied off another artery. ‘You will go now, Sister. I don’t intend to tell you again.’

  Sophy drew a deep steadying breath. ‘That’s a good thing, for I’m not going; not until this case is finished.’ She added ‘Sir’ as an afterthought. She sounded tart.

  He was intent on his work. ‘Unfortunately I am not in a position to enforce my order, Sister,’ and then, pleasantly, ‘What a sharp-tongued little vixen you are!’

  Sophy snorted and busied herself piling discarded instruments into one of the lotion bowls, with a vague notion that she would be able to get them out of the theatre later on. It was the sight of a thin, fitful line of flames mingling with the smoke which caused her to drop the instruments in her hand with a loud clatter.

  ‘Regretting your disobedience, Sophy?’ inquired Max silkily. He held out his needle holder and she inserted a curved needle into it.

  ‘If you mean, am I frightened—yes, of course I am, but I shan’t faint or anything like that, you know.’

  Max didn’t answer this remark, but turned to Dr Walters. ‘I need another ten minutes—will he be all right if you get that machine of yours out of the way, do you think? He’s well relaxed, I’ve got the muscle sheath to stitch—I’ll put in mattress stitches and we can put clips on later.’

  Dr Walters twiddled his knobs, nodded, and disconnected the machine. He slipped an airway into the patient’s mouth, and then, moving fast for once, disappeared with the Boyle’s. He was back within seconds.

  ‘Corridor’s full of firemen and police and so forth,’ he reported casually. ‘Waiting to hose us down if need be, I suppose.’

  He bent over his patient, and the door leading to what had been Edward Block fell into the theatre with a noise like a gigantic nut being cracked, and smoke and flames hurried in after it. The flames, halted by tiled walls and stone floor, hung back, but the smoke crept unhurriedly forward. Max tied the last careful knot with no apparent haste, and took the straight needle and thick gut Sophy was holding out in a frankly
trembling hand. The incision was a long one; it would need at least five of the deep double stitches to hold it securely until such time as the clips could be put on. The flames had found a foothold on the wooden shelves used for the dressings, and had reached merrily for the ceiling with long eager tongues. Max held the gut of the last stitch for Bill to cut, and threw the needle on to a trolley. ‘Start pumping, Bill.’ The younger man put his foot on the lever which would make it possible for them to push the table across the theatre, and Max piled on gauze and a thick pad of wool Sophy had ready. She pushed her trolleys aside and flung several towels on top of the wool and topped them with a very damp one. They were ready to go when Max said urgently, ‘Wait!’

  The ceiling at the far end of the theatre was cracking, making little cheerful popping sounds; the cracks ran like threads pulled by invisible urgent fingers above the stretch of floor they must cross.

  Sophy stood with a small hand on the patient’s covered feet, drawing comfort from the human contact. When Max said, ‘Come here, Sophy, to me,’ she obeyed gladly. He had an arm in a protective arc over his patient, he drew her with the other one close against him, and as she felt it tighten around her she felt quite safe. She hadn’t realised that she was shaking until he said, ‘You’re quivering like a jelly, Sophy. We’re going to run for the door as soon as we know if the ceiling is going to hold or no. When I say so, steady the patient. We’ll do the pushing,’ They reached the door as the ceiling around the burning door caved in, and smoke and flames poured into the theatre. The corridor was packed with firemen and hoses and police and ambulance men. There was no lack of help; within seconds the patient was transferred on to a trolley, covered in blankets, and was being piloted through the throng by two police constables. Centre Block corridor was like Hammersmith Broadway on a Saturday afternoon; nurses pushing old gentlemen in wheelchairs; ambulance men carrying blankets, small children or old ladies; a group of earnest housemen applying heart massage to a patient who had come in for rest and quiet...even the Assistant Matron, looking harassed, struggling along with a waste paper basket full of bottles of pills and medicine. The whole set-up was so unusual that when Staff, unrecognisable in a trouser suit and a rather overpowering fox fur hat, joined their cortege, Sophy accepted her arrival without so much as a lift of the eyebrows, merely asking her in a matter-of-fact sort of voice if she would mind going to Orthopaedic Theatre to borrow the Michel clips holder and clips and some gloves and dressing packs.