by Laney Cairo
He laughed, and sounded much more like the F I knew.
“Honey,” he said, hugging me again and chuckling against my ear. “Your darling med student has left knee prints on the back of your legs.”
I’d miss him. I hugged him back.
“You’re cheerful for someone that’s unemployed,” I said.
He slapped me on my back and grinned, and there was too much twinkle in his eyes. He was either tanked, or employed, and he didn’t smell of booze.
“Smug bastard,” I said. I left him to the tender ministrations of a BMA lawyer and walked through the milling crowd of doctors to where Jane was standing with a group of nurses.
She hugged me, nearly scaring the living daylights out of me.
“I had no idea you were joining us,” I said. “No idea at all.”
“Show of support, sweetheart,” she said. “Thought I’d stand here with you until my shift starts. We all thought that.
The RCN wouldn’t approve any real industrial action, but there’s no reason why we can’t be here while we’re off duty.”
Somehow, the idea of Jane giving up her free time was even more amazing than her going on strike.
I kissed her cheek, and she went bright red and flapped her hands at me speechlessly.
Someone touched my elbow and pulled me aside, depriving me of the delight of seeing Jane with pink ears.
We stood quietly. It was more like a vigil than a strike. We had no placards, just the BMA banner fluttering in the gentle spring sunshine. No one shouted, or ranted. There wasn’t a bullhorn in sight.
I couldn’t bring myself to estimate how many doctors were there. Someone would count us, either from the BMA or the press, who were standing expectantly across the road, obviously hoping we’d behave like coal miners or dock workers, not very sad doctors.
People walked past, some of them staring at us, some of them avoiding our gaze as they walked through the hospital’s main doors.
One little old woman with a stick and a plastic shopping bag walked past us into the hospital and came back a few minutes later and gave a cup of coffee to one of the gynae residents whose name I didn’t know, before returning to the hospital. Hopefully she wasn’t going to be requiring medical attention.
F nudged me with his elbow and said, “Quack.”
Under the circumstances, it struck me as being extremely rude for him to be calling anyone here a quack, and my distaste must have shown because he said, “No, you idiot. Mamma Duck, here come your ducklings.”
Chapter Twenty Nine
Lin walked ahead of me up to Andrew, hugged him quickly and said, “Hello, Dr. M. We’ve come to join you.”
Andrew smiled at her, and he looked pleased. He hugged me in turn, and I had to remember not to kiss him, then he hugged Nevins and the girl with the Lancastrian accent
“Thank you for coming,” he said. “It means a lot.”
“Hi, Dr. Seagate,” I said, and he slapped me heartily.
“Good to see you. I don’t know any of your names, but you’re all Dr. Maynard’s students, aren’t you?”
“Yes,” Lin said. “He told us what happened to you, Dr.
Seagate, and we went to the stop work meetings, too.”
“Aren’t you worried about the impact on your careers?”
Andrew asked Lin.
She shook her head, sending black hair flicking around her shoulders. Damn, her hair was down, she must be going all out to impress Nevins.
“No, Dr. M.,” she said. “I did some reading on the impact of the Irish strike of ’87 on the careers of the participants, and it seemed to have not made a difference. Our career path is only influenced by the support of our clinical referees to a very small extent. Seventy percent of the human resource employment decision-making is based on the applicant’s presentation at the first interview, with the rest primarily based on academic record. Clinical references do little other than prove that we worked in a particular hospital for a period of time. If we all just submitted blank letterhead samples from the hospitals, it would work just as well.”
“Oh,” Andrew said.
Lin looked around her. “Besides,” she said. “I’m sure if we encounter any of these doctors in clinical placements, they won’t hold our presence here against us.”
“You researched this?” Andrew asked.
Lin nodded. “Definitely. I research everything.”
As I found out when Nevins took me aside later on, scuffing his feet and looking embarrassed. “Blake,” he said.
“Can I ask you something?”
“Sure,” I said. “What’s up?”
“Do you know much about girls?” He was looking up at the hospital now, apparently fascinated by the grubby windows.
“Um, not really. I’m gay, Nevins, if you hadn’t noticed.
Why? What do you want to know?”
“I thought you might have, I dunno, been into girls before or something,” he muttered.
Time to confess, before Nevins expired from embarrassment. “Yeah, I had a couple of girlfriends in high school.”
He looked at me hopefully. “Did you have sex with them?”
“Sure, as often as I could persuade them to let me. Then I worked out guys were much more my style.”
“I’ve been reading. You know, trying to, um, work things out, and it’s nothing like the books say,” he said, actually daring to look at me. I felt sorry for the poor bloke; Lin presumably had been researching their sex life, too.
I led him further away from the crowd. “What do you want to know?”
“How long does it take for a woman to, um, orgasm?” he whispered.
“Depends,” I said. “One girl was on a hair trigger, just touch her and she went off. Another girl took hours, used to make my jaw ache every time. And we had to be somewhere completely private. I could never grab a quick shag in the loos with her. Does that help?”
He looked relieved and nodded. “And, um, was she very loud?” he asked, going pink again.
“Some people are loud, men as well as women, some are silent. Some you can hardly tell it’s happened. Loud is good,”
I said cheerfully. “Means you’re doing all the right things. You are using contraception, aren’t you?” I said, partly just from the sadistic pleasure of making Nevins colour even more.
He nodded. “Yeah, Rosanna’s doing that. Triphasil. But we’re using condoms for the first cycle, just to be sure.”
I thought briefly about lecturing him on safe sex, but discarded the idea. Lin seemed to be in charge of things, including Nevins.
“If you really want to know any more detail, you probably need to ask someone who isn’t gay,” I said helpfully. “What about Dr. M? I think he’s been married.”
Nevins looked horrorstruck at the suggestion and I left him quietly whimpering at the thought and went back to join Lin.
Perhaps she would ask me new and exciting questions about what men like, questions that I actually knew the answer to.
I stayed close enough to Andrew to be able to ogle him unobtrusively, just for the entertainment value. He was sombre, everyone was, standing around in groups, talking quietly amongst themselves. No mobiles rang, no pagers buzzed, the young woman from the BMA meeting had swollen eyes from crying. I wondered what it felt like to leave your patients like this. I hadn’t really developed a feeling of attachment to any of the patients yet, and I guessed I wouldn’t until I was really working, perhaps on my long placement next term.
I ate my curry sandwich at about eleven, starving as always, and my eyes settled on Andrew. His key was safely on my key ring, the security code for the alarm system was in my pocket. We were lovers, I was eating his sandwiches, tonight he was going to take me somewhere…
A PCA from our ward came out of the hospital, distinctive in her hideous mint green uniform and pressure-bandaged legs, and I heard her say, “Excuse me, Dr. Maynard, there’s a problem with a medication chart on the ward. You’re needed.”
>
His eyes caught mine as he turned around to pat Dr.
Seagate’s shoulder. He looked completely exhausted.
He walked beside the PCA back into the hospital, the crowd of doctors between him and the door parting silently to let him through. It was the least militant picket line I’d ever heard of.
Chapter Thirty
There was an unfamiliar nurse waiting for me at the nurses’ station, a medication chart in her hand.
She was an agency nurse. Damn.
“I’m Dr. Maynard,” I said to her. I couldn’t raise a smile, not under the circumstances.
She held the chart out to me. “I think there’s been a prescribing mistake, doctor. Mrs. Silva has two opiates prescribed for her. I’ve withheld her ten a.m. dose of pethidine until you can clarify the chart.”
There was nothing I could do, so I took out a pen and wrote ‘cease’ across the orders for morphine and pethidine and blocked out the chart to reflect this. I wrote Mrs. Silva for the maximum legal dose of methadone, added as much oxycodone as I could prescribe, and handed the chart back to the nurse. “I’ll call pharmacy to arrange the methadone.
Please give Mrs. Silva a dose of oxycodone stat.”
The nurse narrowed her eyes at me a little after she had checked the changes to the chart. “Doctor,” she said. “This is a very high dose of opiates for Mrs. Silva. She’s already having trouble maintaining her airway and her respirations are suppressed.”
“Thank you for pointing out the obvious,” I said to her, my patience wearing thin. “If you noticed, Mrs. Silva is NFR. I have no intention of going against her family’s wishes and intubating her. And I have no intention of allowing her to die in pain. Dr. Jackson is the senior consulting physician if you would like to contact him. Excuse me.”
I stalked off down the ward. Hopefully she’d page Dr. Jackson. He wasn’t on strike; he was at his private practice on Mondays. And he’d rip her a new one if she disturbed him there. He was rabidly pro-euthanasia, had even gone to the Netherlands to a euthanasia conference at his own expense, and he was on Jack Kevorkian’s personal mailing list.
I pushed the door to Mrs. Silva’s door open quietly. David, one of the ward nurses, was specialing her, and he looked up from where he was doing mouthcare. John was asleep in a chair beside the bed, his sister’s hand in his own, his face on the bed beside her hand. God, I hoped somebody would care for me so conscientiously in my last few hours.
David stood up and handed me the fluid balance chart and pointed at the tally. I nodded my agreement, flicked through the file to find the IV orders, and ceased the hydration. Her kidneys had shut down; there was no point in continuing to hydrate her.
I could trust David to keep Mrs. Silva’s skin moisturised and to treat her eyes with the tear replacement drops.
David turned the hydration IV off and I just stood for a moment. Mrs. Silva looked younger now, some of her deep wrinkles plumped out by the fluid that was overloading her.
Her colour was bad, her breathing irregular. I didn’t disturb her by listening to her heart and lungs; there was nothing to be gained, there was nothing I could do now.
Good nursing care was what she needed.
“Wake him,” I whispered to David. “He’ll be heartbroken if he’s not there.”
David nodded, and I slipped out of the room.
Clive was the CN on duty, and he was in the treatment room when I went looking for him.
I stood in the doorway while he drew up the antibiotics he was making up and waited for him to finish. Never startle a nurse with a loaded syringe, just in case.
He looked up at me and nodded a greeting as he squeezed the IV bag to mix it.
“Dr. M,” he said. “You came up to see Mrs. Silva? The agency nurse demanded we call you and wouldn’t be talked out of it.”
“Yeah,” I said. Fuck, I was tired. “I’ve put her on oxycodone and methadone. I’ll go and do the request form for the methadone now. Send someone down for me when she dies and I’ll pronounce her.”
Clive nodded. “Will do,” he said.
I left him and went and sat at the nurses’ station where I filled out the requisition form for the methadone, and called the pharmacy to expedite it. The stuff was horribly addictive and pharmacy always wanted to check the usage and counter-approve before dispensing. Paranoid bastards.
I looked up to find myself being smiled at by one of the administration’s flunkeys. He was a human resources case manager according to his ID card, and it sounded ominous.
“Dr. Maynard?” he said.
I nodded and he handed me an envelope and walked off.
Looked like I wouldn’t be pronouncing Mrs. Silva after all. I pushed my dismissal notice into my pocket and got into the elevator.
Matthew was sitting on the pavement, waving what I suspected was a curry sandwich around with one hand as he talked to Lizzie from Micro. The sun was making his hair shine and it was the most gorgeous colour. Not brown at all, more like titian.
Being sacked certainly made one thing easier.
F was drinking a takeaway cup of coffee and it smelled great. I spotted the boxes of coffees lined up beside the statue of some git in a greatcoat with an inadequate gun. I agreed with the pigeons.
I took my coffee back to F and handed him my letter for him to read.
He scanned it and handed it back to me, then took my elbow and walked me across the courtyard to the dank walkway where the homeless lived.
Two shaggy old men looked up at me and one of them grinned toothlessly and held up his cup of takeaway coffee. I held my own up in greeting. Guess it was a good day for them; no rain and free coffee.
F said, “Had you thought about a change?”
“Looks like change has been thrust upon me,” I replied.
“No, a real change. London have headhunted me, offered me a consultancy there, along with a research grant. Come across with me, change to renal.”
I stared at F.
“Nephrology?” I said.
He nodded.
I looked at the two old men in their grimy clothes, made happy by an unexpected free cup of coffee.
“I don’t like nephrology,” I said. “All those blood levels to monitor. Transplants to manage.” I shook my head.
“No?” F said disbelievingly.
I knew that in his little world, there was nothing better than a dodgy kidney, but I’d rather be a general practitioner than deal with renal.
“What do you want, then?” he said. “Go on, tell me what you want. I’ve not accepted their offer yet, I can always counteroffer and include you in the deal.”
“And Clarissa,” I said. “If they sacked me, they’re going to sack her, too. And there’s no shortage of surgical residents out there.”
“Sure, Clarissa, too. So, what do you want? Name your specialty.”
I blinked. F was kidding, right? He couldn’t possibly be serious about this.
“Gastro?” F asked. “Hematology? Rheumatology?
Endocrinology? Take your pick.”
Fuck. This was not a question I’d ever allowed myself to think about. I’d blown my chance of a specialist career path when I’d left the US partway through my first posting as something other than a resident.
“Palliative care,” I said.
F rolled his eyes. “Fuck, Andrew, choose something with a bit of glamour, a bit of lifestyle in it, so you can buy yourself and your pretty boyfriend a decent car each.”
I glared at him and he looked contrite.
“Sorry,” he said. “That was out of line.”
“No problem,” I replied. However bad a day I was having, F’s must be much worse.
Chapter Thirty One
A familiar voice made me look up from my sandwich, and I stood up in time for a pale, but surprisingly neat and tidy, Heidi to bounce into my arms. “Matthew!” she cried, hugging me hard.
Angie was right behind her, blue plastic hospital bag in one hand, bunch of flowers
in the other.
“You’re coming home?” I asked Heidi.
“I am,” she said, beaming. “I’ve got to come back here at the end of the week to have the stitches out, so I’m going to Mum’s for a few days, but I’ll be back at the house on Friday.”
Angie smiled at me. “Say thank you to that nice boyfriend of yours for us,” she said. “I’m going to take Heidi home now.”
* * *
I spent the day listening to the doctors around me talking about their work, their careers, and the responsibilities they carried, and it made me feel very small and inadequate. How was I ever supposed to cope with any of this?
The shadows were slanting across the courtyard and the homeless old men had picked up their shopping bags and shuffled into the hospital, pausing to beg coins from the doctors. My bum was numb from sitting on the concrete when there was suddenly movement; doctors were hugging each other, and Dr. Seagate was going around shaking people’s hands and thanking them.
I struggled to my feet, trying to stamp the pins and needles out of my feet, when he hugged me, much to my amazement, and said, “Is he bringing you along to my place later? After we’ve been to the pub?”
“Um, yes,” I said. “He asked me anyway.”
Dr. Seagate nodded, looking serious. “Make him happy, I’ll love you forever, and believe me, that’s not an offer I make very often.”
I stared at him and he quirked me a smile and turned to talk to the BMA lawyer, leaving me gobsmacked. It had never occurred to me that Andrew might have told someone about me. Especially another doctor at the hospital.
Nevins came over. “Are you coming to the pub? One of the burns unit residents invited us all.”
“Sure.” Nevins was so obviously pleased that I couldn’t resist it. “Just like we’re real people, right?”
Lin walked up just in time to catch this and she shook her head at me. “Leave him alone, Blake, you’ll only make it worse.”
“Make what worse?” Nevins asked.