‘I agree,’ says Nigel. ‘My ENT mate had some bloke come back a few weeks after the op with photos, saying, “This is what I wanted to look like.” My friend did suggest that perhaps he might have brought them in before!’
‘Well, yes, that is a thought!’ I interject. ‘Um, shall we go and see Katie? Her mother is also in the waiting room, if you would like to talk to her?’
‘Let’s do the patient first,’ Nigel says, rubbing his hands and getting out of his chair. ‘No rest for the wicked.’
I escort him to the cubicle and pull back the curtain to find Katie in exactly the same position I left her in: lying on her side, facing the wall, the tubes from the IV drip beside her.
‘Hi, Katie,’ I start. ‘I’ve brought someone along to have a chat with you. To see how you’re doing. His name is—’
‘Katie, I’m Nigel. I’m here to see how you are and see if anyone can help.’ He pulls up a chair. ‘Oh dear, oh dear, you look like you’ve been in the wars. What’s happened to you?’ His voice is kind and his manner is extremely beguiling. She rolls slightly towards him.
I back away out of the cubicle and leave them to it.
‘That your DSH in there?’ asks Ian, walking past.
I nod.
‘Who’s that with her?’
‘Some bloke from the psych team called Nigel.’
‘Nigel!’ Ian grins. ‘He’s a scream. He hasn’t been around for ages. You have to pay two hundred a go to see him now. Hasn’t he got some practice on Harley Street?’
‘Just off Wimpole Street, I think.’
‘He’s brilliant. Very good at his job. He worked for the prison service a while back. Counselling murderers. They’re either mad, bad or sad, he used to say. I remember him telling me about a man who strangled his girlfriend because she threatened to leave him; transpired that he had also killed something like thirty cats, ripping their heads off in the back garden. Sounded like a lovely bloke.’
‘God,’ I say, ‘that must have been a tough job.’
‘No worse than here,’ smiles Ian. ‘You off today?’
‘Yup. Last hour, last shift.’
‘What’s your next move?’
‘Acute Medicine.’
‘Good.’ He nods. ‘A lot less grind than here.’
‘Why do you stay?’
‘What, here? I love it.’ He grins. ‘All the shouting, screaming and vomit. My dad was a pub landlord, it makes me feel right at home!’
Ian walks off, with his bag of bloods to deposit down the chute.
I glance over at the empty consultation room; the peonies and chocolates appear to have gone. I feel a terrible pang of guilt. My mouth goes dry and my stomach churns. I wish I had managed to talk properly to June’s daughter, Audrey, told her how sorry I was that her mother had died, that she looked like a wonderful person, that she wouldn’t have felt that much pain at the end. But then I’m sure Chris said all those things; he is brilliant at that sort of thing. Still, I think I’d like closure of some sort, which is oddly needy of me. I must be tired. Either that or my hangover is creeping up on me.
‘Extra special posh chocolate?’ asks Andrea, walking through the department with a large open box. ‘It is the end of term after all.’
I feel a rush of saliva to my mouth. I’m starving.
‘These are extra special, top of the range, I can’t think why I’m sharing them with you lot!’
I have my hand poised over the box when I realize that it’s Audrey’s box. There is no reason why Andrea shouldn’t have taken them, they’d only go to waste. Audrey was hardly going to come back to collect them, having identified her mother in the chapel of rest. But even so. My mouth goes completely dry.
‘No thank you,’ I say.
‘Are you sure?’ she asks, her plump fingers popping another one into her already full mouth. ‘They’re very good.’
‘Oh, great-looking chocolates,’ says Chris, rushing past and picking up two at once. ‘Don’t mind if I do.’ He puts them both in his mouth at the same time. ‘Mmm, they are very good.’
Back at the far end of the department Jon Berry and his sidekick are finally vacating the area. Well, it is after 5.30 and the end of a very busy day for them, watching other people work. They must be exhausted, in need of a sit-down and a pay rise.
‘Ah, good, there you are,’ says Nigel, his thinning head of hair poking out between the curtains. ‘One quick question.’ He drops his voice to a stage whisper. ‘If I do need to admit her, is there a bed?’
‘Let me check,’ I reply.
He smiles and crosses his fingers at me. I walk to the wall phone just by the computer and spend the next twenty minutes trying to call the psych ward to see if they have any beds. The amount of time I have wasted doing this in my career doesn’t bear thinking about. You call and call and no one ever picks up, and then suddenly you find the line is engaged. Is someone actually finally picking up? Or is it just another sod like you calling in the hope that someone answers? And then, just when you think you might brave the walk up there, some grumpy arse answers the thing and all you want to do is shout your head off about how pissed off you are to have been kept waiting, except you don’t because you want them to find you an empty hospital bed, which as we all know is as rare as rocking-horse shit.
‘Oh, hello!’ I blurt, stifling my desire to shout down the phone. ‘We have a very vulnerable woman in A&E …’
I explain Katie’s case and say that we are waiting for a report from the psych team, at which they nearly hang up. It’s only after another few minutes of grovelling that they allow me to call back on another number and intimate that if I am very lucky they might have something.
As I hang up, Nigel comes up the corridor towards me. ‘So,’ he says, nodding his head towards Andrea’s office, ‘in here?’
I sit and listen as he ticks off Katie’s long list of problems on his fingers. Anorexia, OCD, low self-esteem, amphetamine and laxatives abuse, and more than likely some sort of abuse at home too, either from the father or the mother, he wasn’t sure. Either way he would prefer it if she were kept in and monitored for a while, and she seems willing.
‘So there is no need for sectioning,’ he concludes.
‘Who are you putting away now?’ asks Ian, coming into the office with a broad grin on his face. ‘How are you, me old fruit?’
Nigel stands and he and Ian hug, slapping each other heartily on the back.
‘All the better for seeing you!’ says Nigel. ‘I can’t believe you’re still here. Been passed over again?’
‘Ha bloody ha! Seen any more lunchtime fanny recently?’
‘God, I’d forgotten that!’ He laughs, his eyes rolling. Then he looks at me. ‘It’s not what you’re thinking.’
‘I wasn’t thinking anything,’ I say.
‘You were.’
I was thinking something, but perhaps not what he thought I was thinking.
‘I was supervising shrink for this fellow shrink,’ Nigel explains, ‘who came to me saying he had a problem. He had this client who had come in dressed in pigtails and a short skirt, talking like Minnie Mouse, and then a week later she had come back with a skirt so short you could see her arse in reception, and then when she got into his office she had opened her legs and done the full Sharon Stone. So I asked him what he did and he said that he had said to the woman, “I’m terribly sorry but I can see your vagina, do you want to talk about that?” To which she apparently hit the roof and accused him of touching her.’
‘Oh God,’ I say.
‘The shrink’s worst nightmare,’ he agrees. ‘I mean, he hadn’t handled it very well. He hadn’t talked about his home life enough, or used the word “we” to indicate that he had a partner. Fortunately his practice nurse vouched for him in the end.’
‘And there was the small fact that he batted for my team,’ says Ian.
‘That’s true,’ concurs Nigel.
‘So, how’s everything?’ asks Ian, rubbing his
hands.
‘Oh, I’ve got this great case at the moment,’ says Nigel. ‘A man who gets an erection every time a woman sneezes. And then he has to follow her and rub himself up against her. It has got so bad that he’s in danger of losing his job.’
‘No shit,’ says Ian.
‘Well, I know. He has become so obsessed that it now takes him hours to get to work. He will get on the Tube in the morning and start doing his sums. He has worked out there are more women on the platform than there are in the carriage, that he is statistically more likely to hear a sneeze there. So what happens is that he travels from station to station and gets off every time he can see more women. So it takes him hours to get to work. His wife is very understanding.’
‘His wife!’ laughs Ian.
‘I know,’ Nigel nods. ‘It’s a hard case to crack, and it’s getting worse. I blame Nanny, I think. Perhaps he was sitting very close to his nanny when he was tiny and then she sneezed and he sexualized it. If he hears a woman sneeze in a shop, that’s it. He can be there all day.’
‘He needs to marry someone with nympho hay fever,’ I suggest.
‘Good idea,’ Nigel agrees.
‘And how’s your klepto lawyer?’ asks Ian.
‘Oh.’ His face becomes serious. ‘Now that is a disaster.’ He looks at me again. ‘I was looking after a lawyer with a rather bad shoplifting problem and it was progressively getting worse. Anyway, my colleague and I decided that it was something to do with repressed sexuality, and she finally admitted that she hadn’t had an orgasm for a decade or so. So she was reintroduced to masturbation at the age of fifty-four and we thought that she was doing very well until she was arrested on a double yellow line masturbating in her car outside Marks and Spencer with her pockets full of smoked salmon. She had done the lifting and then been so overcome with desire that she couldn’t control herself.’
‘She wasn’t muttering “This isn’t just a wank, this is a Marks and Spencer wank,” was she?’ asks Ian, half-closing his eyes and frotting himself off.
‘Excuse me,’ says Andrea, looking from the wanking consultant to the sniggering plastic surgeon to the giggling psychiatrist and then to me, ‘I have a phone call for you.’
‘Me?’ I ask.
‘Yes,’ she sighs with irritation. ‘They have a bed for you upstairs.’
6–7 p.m.
Nigel sits in Andrea’s office regaling Ian and David with more of his stories while I try to concentrate on sorting out Katie’s paperwork. I go back out into the waiting room to see if I can have a calm and reasonable chat with Katie’s mother, who is firmly ensconced in the far corner next to the television, leafing through Now magazine. She seems remarkably relaxed for someone whose daughter has just tried to kill herself. But then, it is extraordinary how different people deal with stress. I once treated a woman whose only way of coping with anything too tricky was to fall asleep. She had stress-induced narcolepsy, and every time she was put under pressure, she would keel over. In the end she was put on heavy-duty beta-blockers so nothing really touched her again.
‘Good evening, Mrs Heywood,’ I begin with Katie’s mother.
Her thin, pinched face looks up from studying Cheryl Cole’s fashion tips.
‘Katie’s fine,’ I say quickly, to reassure her. ‘But we would like to keep her in, you know, just to make sure.’
‘OK then,’ she says. Her grey eyes are impassive.
‘She may be in for a couple of days.’
‘Do you need me to sign anything?’ she asks.
‘Katie’s not a minor so she can sign her own forms,’ I reply. ‘But I’m sure she would like to see you now. I’ll find out where she’s going to be so you can come and see her. Visiting hours are four p.m. till eight p.m. You could pop in and see her now if you like. She might also need some stuff. A toothbrush, that sort of thing.’
‘No,’ she says, her nose curling, like she has smelt something bad, ‘you’re all right.’ She gets up. ‘I’ve got stuff to do. She can send me a text later if she wants.’
‘Oh, right.’
I’m not really sure what to do. Try and persuade her to see her daughter, even if that causes more aggro, or just let her go? Atrophied by indecision, I watch her leave. She slopes off, staring at the floor, her shoulders hunched. She’s got the walk of a depressive. I remember talking to a psychiatrist once about depression and she told me that you can always tell a lot about people from their walk. The body has a rhythm, and the way you swing your arms and the balance and motion of your gait can indicate so many things, from depression to the early onset of Parkinson’s. Depressives rarely look up, towards the sky. In fact one of the suggested therapies for depression is to walk, to get the blood circulating, and look up at the clouds. Movement releases endorphins that help improve your mood. But from the way Katie’s mother is walking, she’s not seen the sun or the clouds for months. I’m willing to bet that she would benefit from a bit of therapy herself.
I look around, and the waiting room is seriously beginning to fill up now. There are a few cuts that need stitching, what looks like a dog bite, a broken wrist, some bloke who’s been hit in the face. There are a couple of elderly people sitting in the corner, and one woman who is pacing around tugging at her clothes, looking a little delirious – suffering, I’d say, from an untreated kidney infection. The bins are overflowing, there’s rubbish on the floor, the water-cooler is empty, and the spotty teen on reception is not coping well with the queue of people waiting to be registered. So far so normal. This is the ‘going home from work’ crowd, the slips, the bumps, the scrapes. Soon we’ll get the cooking-dinner injuries, the burns and cuts. And then the drinking begins.
But I’m very nearly out of here. I feel my mood lift as I go back through the swing doors.
Nigel is still talking. Clearly his bennies are working a treat.
‘But they’re not always nutters, you know,’ he declares. ‘Sometimes you have to take their stories seriously.’
‘Yeah, right,’ laughs Ian.
‘No, seriously. I had a mate who was working at Barnet hospital when this bloke came in insisting that he had been poisoned. They didn’t listen, obviously, they told him he had diarrhoea, but he kept on insisting. He did look very unwell so they kept him in, but all that happened was the diarrhoea and vomiting. They tried to grow cultures with his stools but nothing happened. There was no bacteria, which was odd, and the bloke was getting worse. By the next morning my mate, the consultant, came in so the guy asked him, “Are you the senior man here?” To which he replied “Yes,” and the patient asked if he could have a private word. So they disappeared into a side office where the patient suddenly announced that he used to be an agent, that he was once a KGB officer, and now the KGB were after him, they had tried to poison him, and my friend must help him. My friend of course agreed and immediately went off and called the psych team. It wasn’t until a black Merc started circling the building and some blokes in dark suits from the Home Office turned up that they started to believe him. Hilarious, don’t you think?’
‘So who was he?’ asks David, leaning forward over his desk.
‘Alexander Litvinenko!’ answers Nigel, slightly incredulously.
David looks blank.
‘The Russian spy who died of polonium poisoning?’
‘Oh, right, him,’ he nods. ‘I remember that. A bit.’
Before anyone has time to berate David for his extraordinarily crap memory, Louise pops her head round the office door.
‘Oh, hi, there you are,’ she says to me. ‘Um, I just wanted to say goodbye, and good luck, and thank you for your help today.’
‘That’s OK.’ I smile. ‘Are you off?’
‘Yup,’ she says, with a small shrug. ‘See you around … I guess.’
‘Yeah,’ I say, still smiling. ‘It’s been great to work with you. You’re a wonderful doctor. You’re going to go far.’
‘Well, as far as St Thomas’s!’
‘Oh great, I�
�m glad I’ve got you both here,’ says Chris, marching into the office.
We both turn and face him. I’m expecting a little pep talk, wishing us good luck in all that we do, and hoping we’ll remember them when Louise is the foxiest of Max Foxes around, reconstructing faces from small bits of thigh, and I am literally raising the dead as King of Acute Medicine, or a master heart surgeon. Either way I am grand and brilliant. I can also see Louise’s feathers fluff up, waiting for her plaudits.
‘Excellent, great,’ says Chris. ‘OK … so … one of you has to work a double shift tonight.’
‘What?’ says Louise.
‘We are three down and we only have a locum covering for the SHOs.’ His eyes dart from me to Louise and back again. He looks a little sweaty, to say the least. ‘You do the graveyard shift and I promise you can leave at three a.m. It’s nothing you haven’t done before.’
‘We’re not supposed to have to do this,’ says Louise, all irritated. ‘Isn’t that what the European Working Time Directive is for?’
‘Yes, well, tell that to the locum who I know has already done a shift down at St Joseph’s, as that’s where he works normally, and tell that to all the presentations who are planning to pop in tonight with only four doctors manning the place. I know it’s all-change bloody Tuesday, but for three bloody doctors to call in sick – and I use that term loosely – is bloody unforgivable.’
‘Well, I’ve got a barbecue to go to,’ declares Louise.
‘A barbecue?’ Chris looks incredulous.
‘It’s my sister’s birthday,’ she says, a sweet smile spreading across her pretty face. ‘Her twenty-sixth,’ she adds, trying to give a little more significance to the event.
I look at Chris for a reaction. If he is having sex with her, he’s hiding it pretty well. All I can see on his face is irritation and a growing desire to lose his rag.
‘I’ll do it,’ I say.
‘You will?’ both Louise and Chris ask at the same time.
‘Why not?’ I say.
Hospital Babylon Page 13