by Abbie Taylor
She had the top deck to herself. The windows gave off a dirty, metallic smell. From downstairs came the heavy clunk clunk of the windscreen wipers. Passing the common, heading south towards Croydon, Dawn spotted an old man shuffling over the wet grass, carrying a plastic shopping bag. She recognized him. He had been a patient at St Iberius a few months ago. Perforated ulcer; very septic. There’d been a time when Dawn had wondered if he would even make it. But here he was now, she was pleased to see, shaky but out and about. She often recognized regulars in the parks and streets around the hospital. She always found herself checking to see how they looked, whether they were coping, if they were doing well. It was as if, having once been under her care, they were still her responsibility. She was still their guardian, watching over them from the windows as she passed, touching the glass with her fingers to keep them safe.
In the night, the silence woke her. Dawn sat up in bed. Something was wrong! The house was too quiet. Three years of listening out for Dora meant that she was out of bed and halfway down the stairs before she remembered that, of course, Dora wasn’t there any more.
She shivered on the bottom step, feeling foolish. The carriage clock on the sitting-room mantelpiece tick-ticked into the silence. On the carpet, a dark shadow moved: Milly, come from her basket in the kitchen to investigate.
‘I can’t believe you’re moving back there,’ Kevin had complained three years ago, shortly after Dora’s first stroke. ‘Silham Vale’s a hole. A dump! There’s nothing in it.’
‘Dora’s my family,’ Dawn had pleaded trying to placate him. ‘She brought me up. I can’t abandon her now.’
‘But what about our flat here? What about us?’
‘It’s just for a while,’ Dawn had soothed. ‘Just until she’s back on her feet.’
But then had come the second stroke. And then the cancer. The best that could be said for that was that it only lasted a few months.
Towards the end, Dora had developed spasms where her face had twitched and her arms jerked of their own accord, sometimes for hours at a time. Distressed, Dawn had called Dr Barnes out again.
‘Not long to go now,’ he had said in his matter-of-fact way. ‘You’ve done very well to keep her going this far.’ He added, ‘The spasms may mean that the tumour has spread to her brain. I should warn you, sometimes people can notice a personality change.’
Dora had changed. Her plump, kindly face had become thin and sharp and bitter.
‘Call yourself a nurse,’ she spat at Dawn. ‘I thought you could help me. But you’ve done nothing. You’ve just left me here to suffer.’
‘Dora—’
‘Leave me alone.’ Dora struggled to face away. ‘You’re useless. I want to die.’
Hours later, as it happened, a massive blood clot had put an end to it all.
In the sitting-room, on the cabinet, was a photo, its silver frame lit by the orange glow from the street lamp outside. Dora in her back garden, her arm around a child of about eleven in a pink coat. Both of them were smiling. That had been a day to celebrate. The first time in almost a year that Dawn had smiled.
She had worn that coat the night she’d come down from Cumbria, the week of the accident. The social worker had driven around and around the housing estates north of Croydon, searching for Crocus Road. Dawn had sat huddled in the back seat, her hands, her face, her mind all so frozen with cold and misery and despair she thought she would never thaw again. Then the lozenge of yellow on the wet path, the plump figure in the doorway. Dora’s warm arms around her. ‘Welcome, Dawn love. Welcome home.’
You’re useless. I want to die.
After a lifetime of love, the hardest thing to bear was that they were the last words Dora ever spoke.
Chapter Three
Dawn’s alarm went off at five thirty the next morning, the harsh, croaky buzz drilling through the chilly air. The rain was pounding on the window. Dawn stuck her hand out to press the snooze button. Then she lay, face down, her hand still on the clock, feeling as exhausted as if she had climbed out of a mine. Normally she was a good riser, out of bed at the first alarm, her mind bursting with plans and ideas for the day. But this morning, even after her shower, her head felt as swollen and bloated as a pumpkin. She towelled her hair dry, trying to remember what she had timetabled for today. A pressure-sore audit to review. A meeting with a sales rep about a new type of portable cardiac Resus kit. She pulled on her Sister’s uniform, ironed from the night before, and examined herself in the mirror on the back of the wardrobe door.
She smoothed down the uniform. The navy, short-sleeved, polyester dress reached to her knee, cinched in at the waist with a canvas belt. Underneath, she wore dark woollen tights and black, lace-up shoes. In a million years you couldn’t call it a glamorous look – but when you were on your feet all day you didn’t care so much about that. She clipped her ID badge to her breast pocket and straightened her collar. She refastened her belt, positioning it so that the buckle sat dead in the centre.
Then, all of a sudden, she sagged. What was the point? All of this – ward rounds, audits, high-tech equipment – but people still got sick, didn’t they? You could prolong things, drag things out, but no matter what you did people still grew old and suffered and died. Francine was right. Who cared about standards any more? Nowadays people wanted trendy careers – media, sport, fashion. Living-in-the-moment sort of jobs, where you did things for yourself instead of striving for the impossible for someone else. Priya had been an excellent nurse, gentle and conscientious. But she had left now to have her baby, and who was to say she’d ever come back? And in her place; bored, lazy Elspeth and surly Clive. The best, apparently, that the nursing agency had to offer.
Dawn shook herself. What was with her today? One chilly morning and she was throwing in the towel. She collected her coat, bag and umbrella and went out into the dank dawn. Milly watched her to the gate before creeping back to curl up on her warm, fleece, paw-patterned rug in the porch.
Forest Ward was so quiet that Dawn wondered at first if she’d got the time wrong.
‘Where is everyone?’ she asked Lorna, the night nurse. Normally by this hour the overhead lights were all on, the patients out of bed and making their way to the bathrooms, the junior doctors beginning to trickle in for their rounds.
Lorna gave her a funny look. ‘Today’s that big meeting? The research one the posters’ve all been on about?’
The International Research Conference. Of course! She really wasn’t with it today. It was the last thing she felt like doing but she really should go down there and put in an appearance. As the Matron she would be expected to be present, for the opening speakers at least.
‘How was Mrs Walker last night?’ she asked.
‘Bad.’ Lorna shook her head. ‘Hardly got any sleep at all.’
Dawn sighed. ‘I’ll speak to Professor Kneebone again.’
‘He’s been in already,’ Lorna said. ‘Said she’s to be discharged today.’
‘Today? But …’ Through the glass pane in the side-room door Mrs Walker could be seen, trembling and white-faced against her pillows. ‘We can’t possibly send her out today. Look at her.’
‘Sorry, Sister.’ Lorna pushed her bottom lip out in sympathy. ‘He said to tell you he knows how you feel. But he’s got a couple of urgent cases waiting and he really needs the bed.’
The auditorium was a sea of dark suits and white coats. Every seat was taken but still people came pushing through the doors, squeezing down the rows, standing along the walls at the back. Professor Kneebone, nattily dressed in a pinstriped suit and yellow silk tie, stood on the podium and spoke into the microphone.
‘We are delighted,’ he boomed, ‘to welcome this morning some of the world’s greatest experts in the field of Systemic Inflammation. St Iberius is proud of our own recent achievements in this field, some of which we hope to present to you today. Meanwhile, if we could all welcome our first guest speaker: Professor Robert Klinefelter from Philadelphia.’
Applause from the crowd. Professor Klinefelter, very stiff and serious with a tiny brown goatee, mounted the steps to the podium. He cleared his throat into the microphone.
‘Good morning, ladies and gentlemen. My presentation, entitled “Apoptosis and the Neutrophil”, will attempt to explain …’
Dawn tuned out. Her thoughts turned back to Mrs Walker, leaving them today to return to that understaffed home, where by all accounts she would lie alone and uncared-for in some bleak, dead room. The sense of failure was very strong. It went against all of her principles to discharge a patient in that condition. Not only had they done nothing to help her, she was, if anything, actually worse than when she’d been admitted. Her discomfort seemed to have increased by the day. Dawn gripped her hands together. What on earth was she doing, sitting here listening to someone drone on about lab experiments while all the time a real patient was in distress up on her ward? She had promised Mrs Walker that she would help her and now she only had a matter of hours left to think of something. She rose from her seat. As she made her way towards the exit, the people in her row had to turn sideways and pull their feet back to let her pass but no one complained. Everyone recognized and respected Dawn’s navy uniform. In no time at all, she was on the steps, climbing to the doorway with the green Exit sign and out into the cool of the hall.
On Forest Ward, Clive was giving Mrs Walker her breakfast with his back to the glass pane in the door. Even at the best of times Clive never looked exactly thrilled to be at work, but today, if possible, he appeared even more aggrieved than usual. He sighed, rolling his head around on his neck, tapping his foot as he waited for Mrs Walker to be ready for her next spoonful. Watching him, Dawn thought: He really hates this. Working here. Once or twice she had tried to talk to him about it, to find out if there was something in particular bothering him, but he had been abrupt, seeming to resent her prying into his private business. The conversation had gone nowhere. Mrs Walker lay in bed, in her too-large nightgown, looking exhausted after her sleepless night. She twisted her head from side to side, doing her best to avoid the porridge that Clive was thrusting towards her.
‘Eat it, can’t you?’ he snapped, shoving the spoon hard at her mouth.
That was when it happened.
Dawn had her hand on the door, about to enter the room. At the same moment, Mrs Walker lifted her hands to push the spoon away. A pillow became dislodged and she slithered down the bed. The spoon was catapulted from Clive’s hand. A large splodge of grey purée spattered down the front of his tunic.
Clive flung the bowl down.
‘For Christ’s sake!’
As Dawn watched in disbelief, he grabbed Mrs Walker by the arms. Then he hauled her back up the pillows so violently that her head flew back and banged off the bars at the top of the bed. Her eyelids fluttered; she gave a cry of fright and pain.
Dawn pushed open the door.
‘Clive.’ A tightness in her chest, as if she couldn’t quite catch her breath. ‘A word, please.’
Outside the room, she said, ‘What just happened in there?’
Clive, red-faced and furious at having been caught, spread his hands out. ‘Well, what was I supposed to do? She wouldn’t eat the bloody stuff. Kept mumbling instead of getting on with it.’
‘And you didn’t try to find out what was wrong?’
‘She doesn’t know what’s wrong.’ Clive’s lip lifted in a sneer. ‘I haven’t got the whole morning to spend on her. If she hasn’t got a clue what’s happening, she should just cooperate and let the staff get on with their jobs?’
‘Clive. She has cancer. She is in pain. Look at her.’
Dawn’s voice had risen. She was aware of Mandy hurrying over to see what was going on but her field of vision had narrowed, closing off the view around her until all she could see was Clive’s porridge-spattered uniform, his sweaty face, the greasy hair he never seemed to wash. Why on earth was he working in a hospital? This was his eighth week here and he seemed to despise the place more every minute. Why do nursing if you hated it so much? Why come in here, day after day, and treat patients for whom you seemed to feel nothing but loathing and contempt?
She said, ‘Get Mrs Walker her painkiller, please.’
‘I’ll get it when I’m ready.’
‘Excuse me?’
A white dot had appeared on each of Clive’s nostrils. ‘Don’t you tell me what to do. I am a professional nurse. I don’t need you interfering, telling me how to go about my work.’
Dawn was tall enough so that her face was almost level with Clive’s. She drew herself up further. In a loud, clear voice so that he would understand, she said, ‘I am in charge here. And you will do what I say.’
They faced each other, like cowboys in a Western. Clive’s pupils were enormous, black and dilated with rage. For a moment, Dawn wondered what would happen. In all her time as a ward sister she had never reached this level of confrontation with a member of staff. Ever since Clive had started here he had made it plain that he had a problem taking orders from her – muttering under his breath or going about the work with deliberate slowness – but this was the first time he had displayed such open contempt for her authority. Well, he wasn’t going to get away with it. How dare he treat a patient on her ward like that? How dare he! The anger rose in her again. It must have shown in her face because Clive backed down.
‘I’ll get the morphine,’ he muttered.
‘No.’ Dawn had changed her mind. She didn’t want him in there with Mrs Walker. ‘You see to your other patients. I’ll take over here.’
Clive said nothing but his eyes flattened again. He walked away without a word. The ward had gone silent. No one spoke; the breakfast trolleys had stopped squeaking; even the incessant ringing of the phones seemed to have been put on hold. Dawn was aware that she was shaking. What sort of impression was she creating, flushed and large in the middle of the ward? Clive had been out of order but the way she had handled the situation had been completely inappropriate. Humiliating a staff member like that in front of everyone. She’d never done that before, lost control like that. What on earth was the matter with her?
Mandy was beside her. ‘Are you all right?’ Concern in her voice, but a touch of glee also. This was news! The Matron having a meltdown. It would be all over the hospital by lunchtime.
‘I’m fine.’ Dawn made an enormous effort to sound calm. ‘Thanks, Mandy. Have you got the morphine keys?’
In the stock room, Mandy opened the safe and took out an ampoule. She and Dawn signed for it in the ledger. Dawn took the morphine to the side room. Mrs Walker was shuddering and breathing hard, her hands to her face, the most agitated Dawn had ever seen her.
‘I want to go,’ she kept crying. ‘I want to go.’
‘I’m sorry. I’m so sorry. Shh. This will help.’
Dawn injected the morphine into her drip. But a full ten minutes later, Mrs Walker was still trembling, her face contorted, the blip blip blip on her monitor pelting along. Dawn held up the syringe and stared at it in frustration. What was wrong with this stuff? She might as well be giving water.
For the first time, something occurred to her. All along, she’d been assuming that the pain problem was due to Mrs Walker herself. Had she been looking at it from the wrong angle? Could it be the morphine that was the problem?
She returned to the fluorescent glare of the stock room. The two halves of the broken ampoule were still on the counter where she had left them. She picked them up and reread the label. She went through every single word, double-checking each detail. Correct drug. Check. Correct dose. Check. Not out of date … The glass had been intact when Mandy had removed the ampoule from the safe. Dawn had broken it open herself and had not left it unattended for one second between opening it and drawing the contents into the syringe. The company that supplied the drug was a reputable one. St Iberius had never had a problem with their products before.
No. The problem was not the morphine. Dawn shook her head an
d threw the fragments into the bin.
Back in the side room, she sat by Mrs Walker’s bed.
‘I don’t know.’ She gave a sigh. ‘I really don’t know what else I can do here.’
Rain spattered against the window. The roofs of the brown South London housing estates were smudged with cloud, as if the edges had been rubbed out by an eraser. As long as Mrs Walker was here, at least, Dawn could protect her from the Clives and Rude Eds of this world. But in a few hours she would be back at The Beeches where by the looks of that pressure sore she would be left to lie in the same spot day after day. Not one person would come to see her or comfort her or speak up for her. She would be abandoned, suffering and in pain, to live her last days out alone.
‘I’ve let you down.’ Dawn slumped her shoulders. ‘I’ve been useless, haven’t I?’
Mrs Walker moved in the bed.
‘Please.’ Her voice was a whisper. ‘Please. I want to go.’
‘Where would you like to go?’ Dawn leaned forward and took her hands. ‘You tell me, and I promise you, we’ll go there.’
‘I want to go to heaven.’
Mrs Walker was sitting up in her bed. The grey light from the window shone on her face. The lines around her eyes and down the sides of her mouth spoke of her exhaustion. For the first time, her gaze was not moving about, restlessly searching the room, but steady, looking straight at Dawn.
Dawn looked back at her.
She said, ‘You want to go to heaven.’
‘Yes.’
The drumming of the rain continued. Mrs Walker’s eyes remained on Dawn’s. Her eyes were wide and still, and the grey sky was in them.
Dawn felt as if she was in a dream. She squeezed Mrs Walker’s hands. She whispered, ‘Don’t say any more.’