by Joan Hart
At first I did exactly as he said and, surprisingly, I found the tobacco not only moistened my mouth, but it was pleasantly refreshing, too. However, a few weeks later I forgot and accidently swallowed the juice. Shortly afterwards, I realised why you must never, ever do it.
‘Ooh, I feel as sick as a dog,’ I groaned as Dad shook his head in dismay.
‘I told you, didn’t I? Now go and lie down until you feel better,’ he said.
I felt nauseous for the rest of the day. You should never swallow the juice because not only does it cause stomach upsets and sickness, it leaves you in that same state for hours. So, when the young cadets started appearing at the medical centre a little green around the gills, I knew exactly what they’d done because I’d been there and bought the T-shirt.
One day, a young lad rang the bell in the waiting room. I called him through to the treatment room, only I didn’t need to ask what was wrong because it was written all over his face. I’d never seen anyone look such a sickly, pallid colour.
‘It’s my stomach,’ he moaned, clutching it. ‘It’s griping me summat terrible.’
‘And when did this start?’ I asked, gesturing for him to take a seat.
The lad hobbled over like a little old man. He continued to rock backwards and forwards as he explained. ‘It started around two hours ago, Sister,’ he replied with a pitiful moan.
‘And have you been sick?’
‘Yeah, loads.’
‘And have you eaten anything?’
‘No, not a thing. I couldn’t stomach owt, not even my snap [lunch]. In fact, even the thought of it makes me wanna gip,’ he said, placing a hand dramatically over his mouth.
‘And what about tobacco?’
The cadet swallowed hard, took a deep breath and regained his composure.
‘Nope, I haven’t fancied a smoke much, either.’
‘No, I don’t mean to smoke – I mean to chew.’
He rested his baby-faced chin between his fingers and thought for a moment.
‘Yeah, I had some bacca earlier,’ he recalled.
‘And the juice. How about the juice? Did you swallow it when you were chewing?’
‘Yeah, a bit. Well, I mean, I didn’t spit it out, if that’s what you’re on about.’
‘That’s it, then,’ I decided, getting to my feet. ‘It’ll be the tobacco juice. Do you feel a bit like you’re seasick?’
‘Yeah,’ he answered, immediately getting my drift. ‘That’s exactly how I feel.’
‘I knew it!’
I checked the young man over just in case, but it was obvious why he felt so poorly – he’d had a nicotine overdose, only one he’d swallowed. I sent him on his way, with strict instructions to drink plenty of water to ‘flush out’ his system. I told him to come back later if his symptoms got worse, but he didn’t. I knew from bitter experience that the sickness only lasted a matter of hours, so he must have started to feel a little brighter. More importantly, he’d learned to only ever make that mistake once. In a way, doing the same thing had done me a huge favour – not only did I understand how my patients felt, I empathised with them too.
Boys started at the pit as cadets straight from school, usually aged between 16 and 17 years old. Most came from traditional mining families, and they remained as a cadet for around a year, until they’d decided which branch of mining they wanted to go into. Some trained as plumbers or electricians, while others became tunnellers, blacksmiths or specialist surveyors. Despite popular belief, not all cadets ended up working on the coalface; however, they all did their initial training together. In my area this meant sessions on the pit top at nearby Bentley or Markham Main collieries.
They all had to undergo a full medical before they were able to venture underground. This was usually carried out by Dr Macdonald, the Chief Medical Officer, or one of the other Coal Board doctors. They’d check the cadet’s lungs, heart, testicles and ears. A cadet’s hearing would be tested by asking him a series of questions and using an audiometry examination, which measured the ability to hear sounds at different levels. Then it was down to me to check their eyes, take a urine sample, measure both their weight and height, and record any relevant medical family history. I’d also administer tetanus injections as a preventative measure in case they cut themselves on site. However, my work didn’t end there. I’d continue to monitor each and every lad, checking that he was coping with the pressures of being underground. I enjoyed my work and the fact that it was so hands on. Slowly, I not only got to know each and every one of them, I also discovered who was related to whom.
One morning, I was with Bill in the medical centre when the bell rang in the waiting room. I opened the door to find a 17-year-old standing there, clutching his stomach. He looked a little pale and under the weather.
‘What’s the matter, love?’ I asked.
‘Urgh, I just don’t feel right, Sister,’ he groaned.
‘Well, come in and let me have a look at you.’
The cadet walked in and I told him to sit down. Bill was busy with some paperwork and was only half listening.
‘Now, where does it hurt?’ I said, even though I could hazard a guess.
‘It’s me stomach. I’ve got terrible belly ache,’ he grumbled.
‘And have you been sick at all?’ I asked, beginning my usual line of enquiry.
He shook his head.
‘Well, have you eaten anything, then?’
This time he nodded. ‘Yeah, I have … and I’ve shit enough to fill two pans!’
He wasn’t joking. I tried to keep a straight face, but it was a struggle. Then I heard Bill let out a muffled snort from behind. He put a hand up to his mouth and pretended to cough, but it was no good – he couldn’t do it and had to leave the room. The lad looked up, his eyes following Bill towards the door. He watched as it closed and then he turned back to face me. I tried my best not to let Bill’s infectious laughter set me off. Although he’d tried to hold it in, the poor lad must have heard Bill’s chortles from outside because the window was open. I looked back at him and tried to stop the grin from twitching at the side of my mouth. Try as I might, all I could picture in my mind was this poor lad leaping from one toilet to another, filling both. As much as I wanted to giggle, I couldn’t. Laughing was extremely unprofessional, and although Bill was professional at all times, even he couldn’t keep a straight face.
‘Well’ I replied, clearing my throat. My voice was low and serious. ‘You must have eaten a lot of food to do that, because it has to go in your mouth to come out the other end. So, what is it you’ve eaten?’
The boy slumped back in his chair and tried to remember all the culinary delights that had passed his lips since the night before.
‘Well, I had some fish ’n’ chips for tea, and then some crisps, I had a pack of them … cheese ’n’ onion,’ he recalled, counting them off one by one on his fingers. ‘Then I had a burger for supper, and some toast wi’ a bit of jam, a bacon butty this morning and a chicken sandwich – I love me sandwiches, see,’ he insisted. ‘Half a pack of biscuits – shortbread, I think they were – a piece of chocolate cake and a few boiled sweets … oh, and a bit of snap out of me snap tin. A pinch of snuff. Er, did you want me to include drinks …?’
‘No, no,’ I said, putting my hand up to stop him. I’d heard quite enough. ‘Well, it sounds as though you have had quite a lot to eat, but let me take your temperature, just to be on the safe side.’
Unsurprisingly, it was normal. This cadet’s stomach ache wasn’t down to chewing tobacco; it was down to a little greed. After a brief discussion about his digestive system, I sat down and drew him a diagram to explain. Then I asked him to lie on the couch so I could examine him. His stomach felt soft (rigid abdominal muscle and tenderness usually suggest appendicitis), so I wasn’t unduly concerned. Instead, I administered a dose of kaolin and morphine, and asked if he wanted to go home.
‘I can’t, Sister. I’m a trainee; I can’t afford to take time off wor
k!’ he said.
I picked up the phone and called the training officer, explaining the lad’s predicament. The officer knew the cadet would have to be close to a toilet for the rest of the day, so he found him a job working on the pit top. He left the medical centre, promising to call in on his way home after his shift to see the MRA on duty.
‘But if you don’t feel better, then you must go to see your GP,’ I insisted.
Two-pans man nodded and closed the door behind him. Moments later, Bill appeared in the doorway, wiping away tears from his eyes.
‘Has he gone?’ he chuckled.
‘Yes,’ I said, with a grin spreading across my face.
‘Two pans?’ Bill squeaked.
‘Don’t!’
Sadly, he never did report back to us, so we never got to find out what was wrong with him, although I reckon he was just a typical young lad whose eyes were bigger than his belly.
A few weeks later, I was having a cup of tea when the phone in the medical office rang. One of the MRAs, Frank, answered, but his voice changed suddenly.
‘I see,’ he replied, beckoning me over.
‘There’s been a serious injury underground, Sister Hart,’ he said, pressing his hand against the receiver. ‘The first aider wants to speak to you.’
I took it and spoke to one of the underground men. His voice sounded so calm that, for a moment, I wondered if Frank had misunderstood, but he hadn’t. Although the first aiders were highly trained, it never ceased to amaze me just how calm they remained, even in the most fraught situations.
‘Hullo, Sister. We have a man here with a serious head injury,’ he began, before explaining what had happened.
The injured miner had been standing up, about to get off the coal belt, but somehow he’d slipped and caught the side of his temple.
‘What did he catch it on?’ I asked.
‘A corrugated metal sheet.’
I didn’t show it, but inside I physically winced – I knew this was no run-of-the-mill cut or graze.
‘So, what are we looking at?’ I asked.
‘Well, I suspect he’s cut his temporal artery. I’ve applied a pad and digital pressure to the laceration, but his bleeding is very severe and he’s losing quite a bit o’ blood.’
I steeled myself. This was serious; I had to get down there fast. But the first aider hadn’t finished.
‘Sister, I think he’s going unconscious on me.’
‘Right,’ I said, almost dropping the phone in my rush. ‘I’m on my way.’
I wondered what I should do. I couldn’t put up an intravenous drip on my own, and there wasn’t enough time to call a doctor. Despite being a fully qualified nurse with years of experience under my belt, I had never lost my anxiety. In times like these, I’d try to hold it all inside, but my mouth would always feel as dry as the Sahara desert and my heart would pound thirteen to the dozen. I took my nerves as a good sign. I knew that the moment I started to feel complacent would be the moment I should give up the job, because adrenalin always pushed me to do the right thing. However, I knew I couldn’t look scared or even slightly ruffled when attending an accident, even if I felt it inside, as the miners would lose confidence in me.
Come on, Joan, keep it together, I told myself as I grabbed my things.
I changed into my underground gear, while Frank called for the pit ambulance to wait at the shaft side. He also arranged for Pat Sword to accompany me underground. Pat was a trained first aider and an officer in the St John Ambulance Brigade, so I knew I’d have good back-up. As soon as I stepped outside the medical centre I spotted him waiting. I signalled over with my hand.
‘I just need to nip to the lamp cabin, Pat,’ I called as I dashed over the yard to collect my lamp and metal pit checks.
Although Pat was a friendly fellow, very little was said and the mood was sombre as we travelled down together in the cage to the pit bottom. We were both apprehensive about what would greet us. The injured miner had been stretchered close to the pit bottom, so thankfully we didn’t have to travel far inbye to reach him. As soon as I approached, the beam from my headlamp illuminated his figure in the darkness. His head wound was extremely deep and, even with the pressure pad holding his skin together, he seemed to be oozing blood at a terrifying rate. It had covered his head, neck and body – even his clothes were soaked. The light glistened against a wet patch of liquid underneath his body, and that’s when I realised that he was lying in a pool of his own blood. The miner was a man called Ray, or ‘Curly’ as the men nicknamed him because he didn’t have a hair on his head, and he was drifting in and out of consciousness. He had almost gone into hypovolemic shock. We needed to get him to hospital as soon as possible. I glanced up at Pat, who was waiting for instructions.
‘The only way to get good continual pressure to the wound is if I hold it,’ I explained. ‘Here, pass me that thick pad.’
Pat passed it over, and I held it firmly against the wound on Ray’s head.
‘Right, bandage me in,’ I said.
Pat looked at me with his mouth open, as though he’d misheard.
‘You want me to bandage your hand to his head, Sister?’
I nodded. ‘It’s the only way I can keep enough pressure applied and stop him from bleeding to death.’
Pat grabbed a clean bandage and began to wrap it around both Ray and my hand. It was awkward, walking at the side of the stretcher, into the cage and then into the ambulance with my hand attached to Ray’s head by bandage, but I did it. Even with the applied pressure, the patient was still losing a considerable amount of blood, and it wasn’t long before my overalls were soaked through. I took a seat in the back alongside Ray’s stretcher as the ambulance doors slammed shut. We raced straight to Doncaster Royal Infirmary, with lights flashing and the siren wailing. I kept a constant check on Ray because, by now, he was unconscious. Suddenly, his colour began to change. The more I looked, the more I noticed that his face and lips had tinged blue.
I turned to Pat. ‘Something’s wrong.’
Pat helped me as I examined Ray’s head and neck with my remaining free hand. As I felt Ray’s neck, I realised that the cotton bandage, which had been originally applied underground, had tightened with the bleeding. In fact, it had become so tight that it was strangling him.
‘Scissors!’ I shouted. Pat passed them over.
I cut the bandage, and Ray’s face changed colour as the blood began to pump again properly.
‘Thank God for that! He’s getting his colour back,’ I said.
Frank had already telephoned ahead to the hospital, and a set of porters had been dispatched to help us with the stretcher. As we rushed en masse into A&E, a staff nurse stepped forward and stopped us in our tracks. My heart sank. I recognised her because we’d clashed on a previous occasion. Only a few months earlier I’d arrived at casualty with a miner who’d lost the tip of his finger, which had been sliced off by a machine underground.
‘And did you save it?’ she’d asked me at the time, pointing towards the tip of the bloodied digit.
‘There was nothing to save,’ I’d replied.
I could tell she hadn’t been impressed. Although we were both trained nurses, she looked down her nose at me because, unlike her, I wasn’t wearing a nurse’s uniform.
‘Well, didn’t you at least try to save it?’ she’d asked, implying that I didn’t have a clue what I was doing.
‘Well, I would have, but it was hard to see, you know, in the pitch black, among the coal dust,’ I’d said.
After that, she’d taken an instant dislike to me and, unlike the other staff, whenever I arrived with a patient she’d query everything, as though she didn’t believe a single word I said. I was a fully trained nurse, but because I didn’t look like one she treated me as though I was inferior. It was a red rag to a bull, and on a few occasions I had demanded that the casualty officer examine my patients because I didn’t think she’d appreciated just how serious their injuries were. So, as soon as she
saw me walk through the door with my hand bandaged to Ray’s head, she immediately went on the defensive. Deep down, I knew she had me down as a panicker – and I never panicked.
‘What’s the problem?’ she asked, sounding unduly unconcerned.
I looked down at Ray, wondering if she could see what I could – a man with a severe head injury, bleeding heavily, with my hand strapped to him. By now, Ray was fully unconscious and I didn’t have time for her petty point scoring, so I told her exactly as it was.
‘The patient has lost a considerable amount of blood and is going into second-degree shock. He needs to be seen by a doctor, and then he needs to be transfused.’
But, instead of acting on my words, she looked down at me and then at Ray, and shook her head. ‘Well, I think you’re exaggerating,’ she said, ‘so I’ll just take his blood pressure.’
I was soaked from head to toe in Ray’s blood, yet she was treating him as though he’d cut his finger. I was absolutely livid. It was at this moment that I completely lost my temper.
‘You’re joking, aren’t you? Just look at him, you stupid cow!’ I shouted, not caring who heard. ‘Just look at the bloody state of him! This man needs immediate medical attention.’
Pat turned to me with his mouth agape as I proceeded to call her a few other choice names too. It was highly unprofessional and totally out of character for me, but I’d had enough. Ray was my main concern and I was worried a delay could cost him his life. I was shouting so loud that the whole of the casualty department heard, and heads turned to look at me. But I feared that Ray would die, and nothing else mattered – me, her or what anyone thought. Ray was my priority.
‘I want a casualty officer and I want one NOW!’ I bellowed.
The sister heard the commotion and came rushing over. She took one glimpse at Ray and immediately beckoned one of the doctors over. As we transferred Ray from the stretcher to the bed, I was shocked at the amount of blood that had pooled underneath his body.
‘I’ll need his boots off, please,’ the doctor ordered as he got to work.