The staff-nurse handed me the bedside chart: Temperature 102.4 degrees Fahrenheit, Pulse 100, Respirations 25 per minute.
“I'll just examine you now, Mrs Baker ...”
Her face was flushed, skin dry, with a cold sore (herpes febrilis) at the angle of her mouth; lips were cracked, tongue dry and coated. There was no anaemia or jaundice. In the artificial light it was difficult to tell for certain, but I thought that her lips were tinged blue. There was no clubbing of the fingers and no lymphadenopathy. The pulse was one hundred and six, regular, bounding; blood pressure one hundred and ten over seventy, jugular venous pressure not elevated ...
The staff-nurse helped the patient to remove her nightie, and I listened with my stethoscope (which I had previously warmed on the palm of my hand): heart sounds normal.
I examined the respiratory system: the chest moved normally with respiration; trachea was central, and the heart was not displaced. I percussed the chest: the left side was dull at the back. I listened again with the diaphragm of my stethoscope: there was bronchial breathing over the left lower lobe, with numerous fine crepitations.
“Say 'Ninety-nine'”, and I was able to elicit vocal resonance and tactile vocal fremitus.
I completed my examination – the abdomen and central nervous system were normal. I deliberated for a moment, before facing the patient again.
“You have a left lower lobe pneumonia, Mrs Baker ... I'll give you some antibiotics, and we'll soon have you better. You'll have to stay in hospital for ten to fourteen days, though, and be confined to bed for the first three or four of these.”
I turned to the nurse.
“I'll write her up for intramuscular penicillin and streptomycin – do you have it on the ward?”
She nodded.
“We'll try her with some oxygen; also I want a sputum for culture and sensitivities, and a two-hourly BP and TPR chart. I'll write a form for a chest X-ray, and she can have that tomorrow when the department opens... I'll let you get some sleep now, my dear ...” It was half past eleven.
“Now I'd better phone Dr Root,” I informed staff-nurse softly, when we had reached her office. I picked up the receiver with a feeling of exultation, mixed with trepidation at the lateness of the hour, and his possible response.
3
Friday, 11th June: The countryside sailed by – sunny fields and hedgerows, quaint Hertfordshire villages, old market towns and a new garden city. My heart felt light, as I reviewed the last ten days: my emergency admissions, on call with my registrar, Brian Root, on week-days (Mondays and Wednesdays), and with Dr Cottar's registrar, Steve Bolton, over last week-end; ward rounds with Doctors Root and Middleton; the unexpected appearance of Sir Humphrey Golding on the ward to see his two leukaemia patients, just before lunch on Wednesday; then escorting him to his Rolls in the consultants' section of the car park, and finally watching him drive sedately away, with a regal wave – back to London and his main place of work, University College Hospital.
Before May, I had never heard of Hitchin, let alone St Peter's Hospital. How then, Gentle Reader, had I landed up here? On qualifying, I had been advised by the medical school general office to apply for a house job without delay. The school was duty-bound to provide two supervised posts for each of its students, during the first year after qualification – the so-called pre-registration posts. It was only after completing these that we would be deemed fit to take on unsupervised duties, either in hospital or in general practice. As there were always less pre-reg appointments at the London Hospital than the number of students passing finals, the medical school had made arrangements with a number of non-teaching hospitals to take the rest: this ensured that all our students received posts, and at the same time the peripheral hospitals had a regular supply of house physicians and house surgeons of the requisite quality. These linked hospitals were mostly within a reasonable radius of The London in towns such as Bedford, Ilford, Romford, St Albans, Hitchin, where some of us had already been on our student electives. We were allowed to tick up to five boxes on the application form, one of which was marked “Any”. I had chosen four firms at The London Hospital through which I had passed as a student, and had then ticked “Any” as my final choice ...
After coping on my own with calls at dead of night, seeing my patients recover over the ensuing days, being treated with friendliness and totally-unaccustomed respect by the nurses, sisters and even doctors, I had lost much of my fear. However my heart would still race at the sound of the telephone or the buzzing which announced the appearance of the wall-lights – notably the pattern of red, green, yellow and white, which was my code. I was now familiar with all the histories, having admitted the majority of the cases myself. On the Friday morning, I had taken Adam Fenchurch around the wards and shown him the Middleton patients, priming him on potential problems whilst I was away ...
I came out of my reverie at the sight of the tall grimy buildings of London, as the train slowed on its approach to King's Cross Station.
After a filling supper, I sat on the sofa in the small breakfast-room in Oban Road, watching television – Emergency Ward Ten. I had arrived home at teatime with my suitcase; though the hospital laundry routinely dealt with the the resident doctors' dirty clothes, mother insisted that I bring mine home at week-ends, so that she could wash and iron the items personally. From the moment of my arrival, Mum and my sister Jane had hovered attentively, bombarding me with questions, their faces wreathed in smiles. Now, from the corner of my eye, I saw their gaze fixed on me, interested in how I would react to the medical drama series.
I smiled inwardly at the excessively handsome doctors, the flawlessly beautiful nurses, the succession of life and death situations ... I prepared to enjoy myself. Then the telephone rang on screen: my pulse raced, and I felt the perspiration breaking out all over me; a heavy weight compressed the pit of my stomach.
“What's the matter, dear? You look quite pale.”
“I've just remembered something I forgot to do ...”
I rose and hurried out of the room.
4
Saturday, 12th June: Saturday afternoon was warm and sunny – only an occasional wispy cloud rode high in the pale sky, as we strolled arm in arm over Clapham Common, past the pond where fathers and small boys sailed their toy yachts, as they had when I was still at school. Jill Pritchard was due to start her house physician's post at St Thomas' Hospital at the beginning of July: in just under three weeks' time. Her face and fore-arms had not yet lost their deep tan. A soft breeze ruffled her hair when she turned to gaze happily towards me. We hadn't seen each other since our holiday together after qualifying ...
5
Saturday, 22nd May: The train journey had become boring after the first few hours, the views from the window monotonous. The carriage was comfortable, never full, the passengers were cosmopolitan, ever changing; I recognised their speech as French or German, but though I knew both languages, I couldn't follow, because they spoke either too rapidly or too idiomatically. The boredom was relieved by a splendid three-course dinner (with wine) in the restaurant car, over which we lingered for an hour and a half.
We sat in the half-empty compartment through the night, as we couldn't afford a sleeper, the lights low, Jill's head on my shoulder. I dozed sporadically. I was jolted awake by a station stop; it was dark outside. Was this Lyon, the second town of France? I couldn't be bothered to look.
Some time later, I was woken again, we showed our passports, and we were over the border in Italy ...
We breakfasted on coffee and croissants in the dining car. The sun was shining, there was a distant view of mountains, nearer at hand cypress trees, terraced fields, an occasional ox-drawn cart; then factories with car parks containing hundreds of new vehicles ready for distribution. Was this Turin? (“Torino” came over the loudspeaker.) Finally the train pulled into Milan station and stopped. I lifted our suitcases off the luggage rack and we descended onto the hot sun-drenched platform. We had three hours to wait
for our connection to Alassio.
At a kiosk inside the concourse, we treated ourselves to coffee and a sandwich; mine had a cheese filling, and belatedly I remembered that I disliked cheese; however I was so tired that I couldn't really taste it anyway.
“We might as well take in the sights of Milano, while we wait.” Jill was being positive.
However, her usually bright eyes had lost their lustre, were sunken and surrounded by bruised, dark-blue rings; her voice was low and lacked force. She was clearly as tired as I.
Outside the station, the sun beat down on us; we scuttled into the shade of the buildings across the road, dragging our suitcases behind us on their small wheels. A tram approached; we boarded with our burdens, grateful for the shade and the light breeze as we moved off.
“Does this tram go to the Cathedral – Cathedrale?” Jill asked the conductor.
“Duomo, si, sempre ...” he nodded.
The buildings and pedestrians outside passed in a blur. I must have nodded off, because after what seemed a very short time, I found him tugging at my sleeve, and I realized that we had arrived. All I could take in from the pavement was a broad marble façade in black and white, rising to the heavens, and incorporating some celestial statuary. I couldn't concentrate on the details: the day was too warm, my suitcase was too heavy, my weariness too great. Jill and I exchanged glances: without further ado we crossed the road, and took the next tram back, our expedition at an end. Our exploration of Milan had not been an unqualified success – we had not even glimpsed La Scala Opera House!
Everything in Milan seemed to be made of marble. I waited on a marble bench with no back-rest, rather like a coffee table back home, in a cool cavernous marble hall. I looked after the cases, while Jill, who seemed to have more energy – or was it just initiative – went in search of the platform for the suburban train to Alassio.
“Come quickly. It's waiting, almost full – though there's still another hour before departure.”
The train had no air-conditioning, and the seats were wooden; yet there was a festive atmosphere in our carriage, the working classes southward bound on holiday, chatting noisily, laughing, eating. We found two seats near each other, and a man helped me raise our cases onto the wooden luggage rack. He appeared to be the father (il padre?). I sat next to him and two small boys; Jill sat down opposite, with a table between, next to the mother (la madre?) and a slightly older girl; on the mother's lap was perched an infant of about nine months drinking milk greedily from a bottle.
“Piccolo bambino,” I ventured.
“Si, piccolo bambino ...” and we were instantly welcomed into the family, offered lemonade in paper cups which we gratefully accepted, bread and sausage which we politely refused, and cross-examined in incomprehensible Italian.
“Alassio,” Jill contributed. There were nods and a further stream of gibberish. While the woman was admiring Jill's engagement ring, I dozed off again; I awoke with a jerk to find that we had arrived at our destination, and il padre was lifting our suitcases off the rack for us, and helping us out of the carriage with many fond “arrivedercis”.
A taxi took us to our hotel. It was six o'clock when we were deposited at the main entrance.
The Hotel Roma was modern, comfortable and surprisingly luxurious for the price we had paid. After registering and leaving our passports at reception, we were taken with our cases by the bell-boy in a lift to the second floor, where we had two rooms (not adjacent, but both overlooking the sea). After unpacking, washing, cleaning my teeth and changing my shirt, I knocked on Jill's door, and we descended to the dining room for our evening meal.
The spacious chamber was cool, and empty save for a solitary elderly gentleman in a blazer and striped tie, reading a newspaper at his table while drinking an aperitif. He gave us a tiny bow of acknowledgement before returning to his paper. A waiter in bow-tie and tails brought our menu.
We chose Pasta alla Marinara, and he nodded his approval. In halting English he ventured to suggest a Nebbiolo Spumante: we ordered a bottle. The sea-food and cool fizzy wine were excellent after our prolonged fast, but the effects of the alcohol, the long journey and the lack of sleep hit us before we had finished. We rose to leave the dining-room; half-way out we encountered two attractive young ladies in full length evening gowns who were just arriving.
“Good evening,” they addressed us in accented English, with a smile.
Upstairs, I parted from Jill, entered my room, and lay down on my bed before completing my unpacking. I closed my eyes for a minute. The sea sighed softly on the beach as the tide crept in ... I woke up on the bed next morning, fully clothed with the sun streaming through the open window, the curtains flapping in the light breeze.
After a breakfast of rolls with damson jam and coffee in the empty dining-room, we spent the morning on sun-loungers on the hotel's private beach, I in my navy blue bathing trunks, and Jill in a chocolate-brown bikini, whose top revealed more than it hid. On the incoming breeze I picked up the whiff of ozone and sea-weed, the unmistakeable smell of the seaside. We relaxed in the warm sunshine, toes in the soft fine sand, murmuring to each other, occasionally touching hands. Cool lime juice was brought out to us by a white-jacketed waiter, around mid-morning; while we sipped it we watched the tide slowly advance towards us. We paddled in the sea, the water feeling cold after the heat of the sun. The place was deserted, save for a pedalo visible a long way off-shore, and a tiny couple promenading on the sand at the water's edge in the distance.
In turn we anointed each other with sun-tan lotion: I thrilled to the touch of Jill's silky skin – as my finger-tips caressed her shoulders, back and upper arms. When we had finished, I donned my sun-glasses, lay back on the sun-lounger and dozed.
I felt eyes on me, and awoke to find the two young ladies from our hotel standing over us, casting the shadow on my face that must have disturbed me. Now they wore beach robes over minuscule bikinis (one a scarlet polka-dot, one virginal white); both had loosened their blonde hair, so that it hung down to their shoulders, and both were disguised with large fashionable sun-glasses.
“Good morning,” the taller one addressed us in excellent English.
“We met you briefly in the dining-room yesterday evening, but you looked travel weary so we didn't want to detain you with conversation ...”
There was a slightly awkward pause, while I wondered what to reply.
“But how are you this morning?” she continued. “Seems as though the good weather will continue ... I am Greta and my friend is Marianne.”
We introduced ourselves, and they duly admired Jill's ring, exchanging significant private smiles.
“May we sit with you?”
They brought sun-loungers from a stack nearby, discarded their robes, and proceeded to lubricate each other voluptuously with oil from a bottle, until their bronzed skin shone in the bright sunlight. They had perfect figures, the sort that would draw the male gaze from miles around, but apart from me and the waiter (who had appeared like a jack-in-the-box to take their orders), the display was wasted – the surrounding beach remained deserted. We learned that they were air hostesses with the Dutch air-line KLM, that they had been here two days already, and that they were due to fly back to Amsterdam on Wednesday.
Greta, the taller of the two, addressed the waiter peremptorily in rapid Italian; he departed, to return in ten minutes with a tray of salad, prawns and spaghetti on four plates, and a couple of cocktails for the girls, in tall glasses with slices of lemon, ice cubes and small paper umbrellas. I marvelled at the sophistication of these young ladies who seemed no older than Jill and myself.
“While you are here, you must take a coach trip to Portofino ... See how the rich live.”
The girl in white, Marianne, was quieter than her friend, though no less beautiful.
“Also, a trip along the Riviera and across the French border to Nice. They should enjoy that, shouldn't they, Grete?”
We nodded enthusiastically, and agreed we w
ould try to book the trips from hotel reception. The conversation continued intermittently until we had finished our drinks and our sea-food snack. Then, still in leisurely mode, I donned my cover-up shirt, and Jill her hotel towelling-robe. We rose to return to our rooms for a siesta, but Greta interrupted our goodbyes.
“I nearly forgot, you must visit Jimmy's! It's the only decent night-club in Alassio ... About half a mile into town. We're there practically every night – great fun. You will enjoy ...”
We nodded again, smiled, waved and left.
6
Wednesday, 26th May: The coach was almost full, and we wondered where all the passengers – lightly dressed tourists like ourselves – had come from. It raced down the empty coast road, heading west. On our left were views of the sea, the sun sparkling on the shallow waves, the beaches virtually deserted. A tiny steam ship appeared on the horizon, and nearer at hand I saw a luxury motor yacht, its sail furled, maintaining a parallel course to ours . On our right were rolling countryside, lines of lemon trees and a backdrop of green hills. We passed through several villages, the resorts of San Remo, Menton (more lemon trees), and then we were across the border in France.
The Corniche, on the French side of the Riviera, was steeper with more hair-pin bends, the views more spectacular, more vertiginous. However the coach driver drove smoothly, competently, and we were able to relax, to enjoy the ride.
“We now in Principality of Monaco ...” he informed us in broken English.
Death on the House (Edwin Scott Crime Trilogy Book 2) Page 2