Demons

by Wayne Macauley

  If we could offer these guys a bit of money, she said, I see no reason why they couldn’t play patients for us, at short notice if we needed, on the day for example when we had our ward inspections. We’d give them a name, age, background, ailment and a list of symptoms and ask them to swot up, then we’d ‘admit’ them and have them on display when the ward doctors or auditors came around.

  But how do we pay them? I said. From the Christmas fund, said Beckie. What Christmas fund? said Keely. The Christmas Fund, said Beckie, that we get all the other guilty nurses to contribute to—the Christmas fund that will ‘pay for dinner and drinks and a visit from Santa’ at the end of the year. Keely, Heather and I took a while to catch on. We’ll let the others who know what we’re doing but who don’t want to be involved ease their consciences by contributing: it’s a small payment, we’ll explain to them, for the benefits we’re bringing to your wards. They won’t disagree, trust me, said Beckie. To the Christmas Fund! she said, and we all raised our glasses.

  It worked a treat. We gave Hayden cholelithiasis, gallstones, a mild attack. We called him Callum Broadbent. We brought him in through the back door, doctored the records to show he’d come in the night before through Emergency, marked up his chart to say he’d been given morph on arrival and endone since and that he seemed to have settled down. We had him set up in bed watching telly when the ward doctor came through that morning around eleven. The doctor was in a hurry—they are always in a hurry. He checked the patient’s chart, asked him a few questions, pulled the curtain around and lifted Callum’s gown and pushed down here and there. Callum winced, as rehearsed, and said it was still a bit sore but nothing like last night when, he said, he’d been doubled over with pain and couldn’t walk. The ward doctor said it seemed to have settled—he’d send him home that afternoon with painkillers and instructions to go back to his GP in the next couple of days. If it flares up again, said the ward doctor, he may need to do something about it. The doctor left, and Keely, shadowing him, texted Beckie and me: Gallstone patient all clear. That afternoon we gave Hayden his payment and sent him on his way.

  The next day, and each day after that for two weeks, we moved about half-a-dozen of these ‘performance patients’ through. We never gave them anything too complicated, an hour’s preparation at most and nothing that was likely to get them rushed off to surgery. We’d email the actor their patient name, age, condition; they would do the performance and we would pay them thirty dollars an hour cash on discharge. Pretty soon we’d got our numbers back up to the same level as before but now we had real patients in our beds and doctors as eyewitnesses to it. It was going well. The auditors came back sniffing occasionally, like a dog who’s left something behind, but we always had new patients ready to shut them up.

  One day, an auditor came down to do the rounds accompanied by a bigwig supervisor woman with a lanyard and reading glasses on a chain. I had the great pleasure of showing them around one room in the ward where every bed had an actor in it and every performance was pitch perfect.

  Well, said Abbie, standing up, I suppose we should get moving. We walked outside, the heat was like a wall, the car door handle burning to the touch. And it was funny, I remember, said Megan, when we got back in, there was a moment of hesitation: what was I doing with this woman, listening to this story? Because all the while I’d been listening, in the car, in the roadhouse, I was actually having more and more trouble believing it—I mean, it was far-fetched to begin with but now it just seemed crazy. Did all this really happen, I was thinking, actors playing patients in the public-hospital system to dupe money out of the authorities, or was it some kind of kooky fantasy of Abbie’s that she was telling me to pass the time?

  It’s bullshit, said Marshall; no-one could pull off something like that, not with all the checks and balances in place nowadays. You think she was having me on? said Megan. They all shrugged. Tch, I knew it, she said, almost to herself.

  It was still pouring. The pot bell went off. Leon got up to empty it.

  All right, said Evan, fuck this. Anyone? Yeah, said Marshall. Yeah, said Hannah. Beside the fridge, said Lauren. Yeah, said Adam. Yeah, said Megan, all right. Half, said Lauren. Evan was bouncing up and down on the balls of his feet. And the San Pel, said Leon.

  I can’t believe all that was a lie, said Megan, falling back into the cushions. I so believed it when she started. It probably was true, said Adam, to some extent; they probably did add some phantom patients to the lists early on, but then she got caught up in the storytelling. We’ve all done that: does it matter? No, said Megan, I suppose not.

  Ah! said Marshall, without sitting up from his slump, so when a politician tells a lie it’s a hanging offence but when anyone else does it and says it’s a story, that’s fine! Yep, said Lauren, that’s pretty much how it goes. It’s a harmless lie, anyway, isn’t it? said Hannah. But politicians’ lies, Marshall, they can hurt people. Megan’s hurt, said Marshall, look at her; her driving companion pulled her leg and now she’s hurting. Megan gave him a wincing smile. Evan came back from the kitchen with two bottles of wine, a bottle of mineral water and seven glasses on a tray. Can you bring some cheese and crackers too? said Lauren. Jesus! said Evan. And take the empty cups back? said Megan. Jesus! said Evan, again. He’s a good boy, isn’t he? said Megan. He is, said Leon, grinning.

  So, Adam, said Marshall, you’re the lawyer: why do we think this Abbie woman was lying? We believed her at first, for a while, and then we didn’t. Well, said Adam, I guess in the first place because we are hearing her story via Megan and as Megan became less convinced that the story was actually true, something in her demeanour started sending out signals to us. We began to read not the tale but the teller. Adam lined the glasses up and started pouring the wine. In law, he said, we have this ancient principle called ‘legal fiction’. It basically means that something can be considered true even though it might not be. For example, a man, A, finds a bag of money in the woods; another man, B, comes along and says it’s his and takes A to court to have what he says is his bag of money returned. I was riding through the woods on my piebald horse with the lame off-hind, says B, on my way to my sick brother’s house to offer help to his poor wife and children and it must have fallen out of my saddlebag. The judge finds in his favour. There is no evidence, there are no witnesses. The judge just believes. Under the tenet of legal fiction, said Adam, a story no matter how unlikely can sometimes seem most true—and so will become, for legal purposes, actually true. Many anthropologists, he continued, believe we are the only animals capable of lying and that this is in many ways what distinguishes the human species and probably played a large part in our evolutionary success. So is it right to hold against us the very trait that separates us from the apes? Our ability to fib? We have Art, said Nietzsche, said Adam, so that we may not perish from the Truth.

  He put the bottle down. Evan came back with the cheese and crackers: he had another bottle dangling from his fingers.

  Where do you get all this shit from? said Marshall. How do you remember it all? I guess because it’s worth remembering, said Adam. Evan put the things down. Not everything is worth remembering, said Adam, in fact, you could almost say that most of what people concern their heads with these days is not worth remembering at all and should be allowed to slip unnoted into history’s abyss. But that’s not the way it is, is it? He sipped his wine. Actually, most of us remember the stuff not worth re
membering; the pointless, trivial stuff. But there’s always a few swimming upstream, Marshall, trying to hang on to what might be useful.

  Woo, said Evan, sitting down. Yeah, said Megan. I like listening to this, said Hannah. Go on, said Leon. Yeah, said Lauren. Well, said Adam, taking up a cracker and spreading it with King Island brie, I think we’re living through interesting times, so far as truth is concerned. And one of the main reasons is that we have confused it with facts. Facts, to my mind, are as little to be trusted nowadays as lies, because there are so many of them. Call it data, if you like. But just because there are all these facts doesn’t mean we should listen to them. In fact (ha!), when so-called truth comes at us in an avalanche like that, a thousand tiny bits, shouldn’t we be more inclined to distrust it? Mightn’t we be better off cutting through all the crap and like the judge in the case of the bag of money in the woods actually trust our instincts? Believe the unbelievable, even if—or because—it is a lie? Mightn’t we be better off looking to get our truth these days through an artifice that truthfully says it is one?

  Leon started clapping, a wry smile on his face. Art is going to save us, said Lauren, flatly. Maybe art can, said Adam, with a flourish of fingers, for the reasons I’ve just said. Reason, logic, science—they’re exactly what got us into this mess in the first place.

  That’s a pretty sweeping statement, Adam, said Marshall, sitting up slightly, especially coming from a lawyer. That everything since Plato and Aristotle—reason, logic, law, government, civilisation—has been a waste of time and we ought to ditch it and start making up stories and plays and songs instead. When you put it like that, said Leon, actually, I’m with Ad. Me too, said Hannah, politics is fucked. It’s a power trip, she said, it’s got nothing to do with making the world a better place—sorry, Marshall, but it’s not just me; ask half the world and I’m sure they’d agree. What Adam’s saying, she continued, a slight flush to her cheeks, is that the great enlightenment experiment has failed, reason has not saved us, and we’re no closer than ever to understanding why we’re here and what we should do, how we should get on, live with each other, communicate, share. All the systems we’ve put in place have failed. It’s like that Japanese nuclear plant: we have systems in place, it’s all under control—then along comes a giant wave. Global capitalism: we have systems in place, the market can absorb the shocks—and then. All that logic of systems starts to look pretty shaky, doesn’t it? And all Adam’s saying, I think—sorry Adam—is that in this kind of truth-poor environment maybe we need to look somewhere else to figure out how we should live?

  Hannah was on the edge of the couch. Leon had a hand on the small of her back—it was hard to tell if he was holding her back or pushing her forward. Marshall, on the other hand, had slumped down again as if trying to protect himself from the blows. Well yes, said Adam, but I guess we should let Megan finish her story—I don’t think she was asking for such a long answer to her question.

  Phew, said Megan, shaking herself. So what was the question again?

  They all laughed.

  It had just gone five and an early winter evening was coming down. The sky was backlit, glowing. Evan looked out. I wonder how the Saints went? he said.

  The rain was still coming in waves, slapping the roof, the windows, the walls. Everything strained and creaked. You could hear the legs of the table outside scraping across the deck and from everywhere a cacophony of gurgling, splashing, slurping. The sound of earth sucking water seemed to outdo even the mighty sounds of the sea.

  So, said Megan. The roadhouse on the way to Oodnadatta. Abbie behind the wheel. What next? she said. Well, she continued, after the big success with all the actors in the ward that day, Keely, our go-between, dropped out. She said we’d got ourselves in too deep. So now it was just Beckie, Heather and me.

  Well, the first result of this, said Abbie, was that the actors got cold feet too. The whispers went down the line, saying how Keely had bailed, and that sent a panic through them all. We rang around, tried to reassure them, offered more money, but they weren’t interested. In fact, they thought we were crazy—and we probably were.

  I’d wanted to be a nurse all my life, had sacrificed everything for it, and now here we were, just the three of us, taking all these risks, putting our careers on the line—and for what? A few extra dollars dropped into a broken system, money that should have been given to us without strings attached years ago. What we were doing had outrun our reasons for doing it; we were playing with patient lists now just because we could. But were we making any difference?

  Then one day the nursing supervisor called the three of us into her office. She was a big woman, and that morning she seemed to have puffed herself up to twice her normal size. She started talking about the pressure we were all under, how we were all in the same boat, how stingy funding affected us all, not just the radical few; we are all fighting the same fight, she said, fiddling with her lanyard, and she would be the last to discourage suggestions from her staff about ways to improve efficiency. If one group of nurses is managing to clear their backlogs quicker than the others then she would be remiss in her duty—wouldn’t she?—if she didn’t enquire into their work practices to see if there might not be something there that she could adopt in other areas of the hospital. That’s only natural, she said. But in doing this, you see, girls—she called us girls—in doing this enquiring, we have uncovered a couple of anomalies. It’s understandable, of course, in a big public hospital, accommodating thousands of patients every week, that there might be a few record-keeping oversights. Maybe a patient has been wrongly assigned, maybe a patient has, according to the records, been discharged early, or late; sometimes we might even have patients on our records who don’t seem to exist, or, at least, when we go looking for them, we can’t find them.

  Of course, said the supervisor, there may be a perfectly reasonable explanation: the patient has been discharged and (unforgivably, I would have to say) the records have not been updated. Perhaps—I suppose this is possible—the patient has been transferred to another ward of the hospital and, again, surprisingly, the records have not been corrected. Or perhaps a really bad admission error has been made. John Smith, say, has been entered as Jim Smith, say, and when John Smith is subsequently found lying in a bed in 4 East and the record corrected, the non-existent patient, Jim Smith, has somehow—I don’t know how—been left in the system? It seems far-fetched, true, that a professional nursing team could do that, but you never know. Or—let me speculate again—perhaps the patient whose name and details and medical history appear on our hospital records never existed at all? Now there’s an idea. This one, for example, I wonder who she is?

  The supervisor, said Abbie—hands on the wheel, glancing sideways at me—was holding up a sheet of paper so we could read it. Jacinta Rose, she said, female, thirty-two, severely infected cyst, upper right jaw, admitted yesterday am, operated on pm, moved post-op to Bed 9, 4 North late yesterday evening. But we can’t find her. Anywhere. Shall we go up and have a look?

  It all happened so quickly, the supervisor had barely finished the sentence before she was out of her chair, the sheet of paper rolled up and thrust in front of her like a pointing stick. We followed her into the corridor. She started making small talk—It’s a lovely day—Do you have weekend plans?—There’s the new IV—and we tried to stay on topic. Yes, it is—No, not really—That must have cost a fortune.
But we knew we were going to the gallows.

  When we got to the lift I excused myself, saying I’d left a patient for a urine sample in the toilet on my ward, and before the supervisor had a chance to object I headed for the stairwell. I came out on the fourth floor looking like I’d run a marathon and raced to the nurses’ station where Ange, one of our original members, was on duty. Hurry, I said, the supervisor’s coming, get me a gown, a bandage and a shaver or I’ll tell her you’re in on it too. Ange did what I said. In the toilets I stripped, hid my clothes in the sanitary bin, shaved half my head and flushed the hair down the toilet, wound the bandage around my jaw then ran to Bed 9, got in and ‘fell asleep’.

  The sheet had only just settled on me when I heard the click-clack of the supervisor’s heels. Then I heard Beckie’s voice. Yes, here she is, she was saying, it looks like she’s sleeping; I think we’ve got her on morphine so it’s probably best not to wake her. I heard the footsteps stop, then felt the shadow on the window side as the supervisor looked down at me. It was quite serious, Beckie was saying, and they had to remove some surrounding tissue; even her mother wouldn’t recognise her when she came back from theatre. That was the last thing I heard before I felt the supervisor’s fingers, pulling at the bandage.

  So, said Abbie, that was that. We were dragged up before the hospital board, the others too, and asked to explain ourselves. There wasn’t much to explain. The union backed us for a little while but then they saw the error of their ways. We’d brazenly manipulated the patient records of a well-known public hospital and we were going down. Forget about the public good, the means justifying the ends—there are systems in place to prevent that kind of thing.