The Dilemma

by Abbie Taylor

  She finally tracked him down in the stock room, most unusually for him, busy changing over the sharps bins, sealing the full one for disposal and opening up a fresh one. It was unlike Clive to do something he hadn’t specifically been asked to do. He was obviously making a huge effort today.

  ‘If you’ve got a moment,’ Dawn said, ‘could we have a talk?’

  Clive’s eyelids lowered, turning his eyes into hooded, hostile slits. But he said nothing. He peeled off his gloves and followed Dawn to her office. There was just enough room to close the door. Dawn cleared a pile of Nursing Today journals from the only spare chair and placed them on the filing cabinet.

  ‘Please,’ she said, ‘sit down.’

  Clive sat on the very edge of the seat, barely touching it, as if the plastic might scald his rear. Down the front of his tunic hung a silver chain with a large, chunky medallion on the end. His lips were so thin they had all but disappeared into his face. Despite her anger, Dawn felt almost sorry for him. After hearing about Mrs Walker’s death last week, the chances were he had passed a very unpleasant weekend.

  ‘I’m sure you know why I’ve asked you in here,’ she said. ‘It’s about what happened on Thursday. With Mrs Walker.’

  Clive said nothing but his lips vanished even further into his face.

  ‘I’ve been thinking hard about it,’ Dawn said, ‘as I’m sure you have, too. And I’ve come to a decision. Provided nothing like this happens again, I don’t intend to take things any further.’

  Clive’s taut expression didn’t change. But the drop in his shoulders showed that he had suddenly exhaled. Definite relief. Surprise too. Dawn caught the flash as his eyebrows lifted.

  She said firmly, ‘That’s provided nothing similar happens again. Any further mistreatment of a patient will be taken much more seriously. If you’re busy and finding it difficult to cope, then ask someone for help, or come and speak to me about it. But you don’t take your problems out on the patients. Do you understand?’

  ‘Yes, Sister.’

  Definitely meeker than usual. Close up, Dawn saw that he had shaved off all his stubble. His face looked much less unhygienic than usual. His hair was washed and tied back in a ponytail instead of straggling down over his collar. The only jarring note was the chunky medallion dangling on the front of his tunic. She might as well deal with that as well. Get everything sorted out while they were here.

  She said, ‘Clive, I’m sorry, but there’s one more thing. That chain will have to go. I’ve seen it touching the patients when you’re treating them. It’s an infection risk. The policy on the ward clearly states minimal jewellery only.’

  Clive’s head came up. ‘But it’s my allergy chain.’

  ‘Your what?’

  ‘I’m allergic to penicillin.’ He lifted the medallion to show her. ‘See?’

  On the front of the medallion, the words Penicillin Allergy were engraved around a central, raised carving of a skull.

  ‘I didn’t know you were allergic to penicillin.’ Dawn tapped her pen on the desk.

  ‘Yeah, well, I am. And my allergy specialist said it’s vital I keep this warning on me at all times.’

  Dawn was familiar with the concept of allergy alerts. Lots of people carried them. Just not normally so ostentatiously.

  ‘Couldn’t it be something smaller?’ she asked. ‘A bracelet? Or a thinner chain?’

  ‘A thinner chain might break,’ Clive said. ‘Anyway, it has to be big. That’s the whole point. It’s a serious allergy. I could die.’

  He spoke in a very earnest tone but deep in his eyes was a triumphant smirk. This will show you. Don’t think you’re going to have it all your way. HR would back him up on this one and they both knew it. You couldn’t argue with an employee telling you they could die.

  Dawn kept her tone neutral. ‘Fine,’ she said. ‘If you need to wear it, I don’t have a problem with that. But try to keep it inside your tunic. It shouldn’t need to dangle over the patients.’

  ‘No, Sister.’

  The air seemed cleaner and fresher when he had left. Dawn exhaled, blowing out her cheeks. So that was over. Let Clive have his victory over the chain. His hygiene and attitude had improved and that was the main thing. She doubted very much that he would abuse a patient on her ward again. But she’d be keeping a close eye on him from now on. Either he treated the patients with courtesy and respect or he lapsed again and he was out. It was entirely up to him.

  Even with the windows open, the sun beat through the glass into the bus, trapping a stifling heat in the seats. The passengers, caught by surprise, were carrying their coats on their arms. It was the first of May and, overnight, summer had arrived. Wandsworth Common was filled with people sitting with their trousers rolled up, their faces to the sky. Couples lay sideways on the grass, giggling and playing with each other’s fingers.

  Whether it was the change in the weather or the relief of having dealt with Clive, Dawn didn’t know, but the dragging sense of sadness and unease that had weighed her down over the past few days seemed, very slightly, to have lifted. Looking out over the dappled grass, it was as if she’d had a revelation. She could see now how all of this trouble had started. How the incident had happened with Mrs Walker. She’d been too caught up with things at work. With nothing going on outside of the hospital to distract her, her sense of her own importance had inflated until things had got completely out of hand.

  Francine’s warning: You need something outside, too. You need to keep your perspective.

  The thing was, it crept up on you. Work. For a start, there’d been all that preparation for the Matron interview. You didn’t just walk into a post like that off the street. There’d been courses to attend, journal articles to read, management exams to pass. Then when she’d finally got the job, there’d been all the extra hours at the hospital, finding her feet in the role.

  And in her spare time, of course, there’d been Dora.

  Dora’s first stroke had happened three years ago, one windy morning in March. She’d been in the garden hanging her washing out, when with no warning at all, a hidden blood clot in her neck had broken free, floated upwards and lodged in her brain. She was found by a neighbour, hours later, lying on the grass, unable to move or speak.

  Dawn, summoned urgently from the London flat she’d been sharing with Kevin, her boyfriend, had rushed on to the ward to be greeted by Dora, almost swallowed up by her giant, inflatable, anti-pressure-sore mattress, looking tiny and terrified and half the size Dawn had always known her. Strong, independent Dora who had raised her young son single-handedly after being widowed at the age of twenty-three, who in her fifties had started all over again, taking on the full-time care of an orphaned granddaughter, now lay slumped and helpless to one side of the bed because her muscles refused to support her. The corner of her mouth hung down, dripping saliva on to her chin. Dawn, hiding her distress, clutched her hand. Dora’s speech sounded as if someone had stuffed a large dishcloth in her mouth, but with a little effort Dawn could understand her.

  ‘I’ll be all right,’ Dora kept saying. ‘I’ll be better in a week or two. Don’t worry about me.’

  The consultant sat down with them to discuss her prognosis.

  ‘The scan shows a lot of damage, I’m afraid,’ he said. ‘Mrs Torridge may make some recovery as time goes on, but …’ He hesitated. ‘Do you live on your own?’

  He was speaking to Dora but it was Dawn that he looked at.

  ‘Yes,’ Dawn said, ‘she does.’

  ‘Have either of you considered the possibility of long-term care?’

  Active, busy Dora tried to hide her shock. ‘Fine,’ she said. ‘If that’s what I’ve got to do, then I’ll do it.’

  But Dawn knew that one of her grandmother’s greatest fears had always been to lose her independence, to have to go into a home or a hospital. When the doctor had left, Dawn tried to console her. ‘We’ll work it out, don’t worry. We’ll keep you in Crocus Road.’ And Dora, breaking down
at last, had cried and tried to touch Dawn’s cheek with her hand.

  Dawn moved back to her childhood bedroom in Silham Vale.

  ‘Just for a few weeks,’ she assured Kevin. ‘Just until we sort things out.’

  There was a lot to organize. Dawn arranged for carers to call during the day while she was at work to get Dora out of bed and help her with her lunch. In the evenings, Dawn took over. She fed Dora, washed her and changed her, gave her all her medications. Dora objected to the amount of time Dawn was spending with her.

  ‘Go back to your flat,’ she kept saying. ‘I’ll be all right here with the carers.’ But she was still very shocked and teary and Dawn knew that, for now, she was the one who made Dora the most comfortable. She was so used to doing it for the patients on her ward. She gently cleaned Dora’s eyes and ears, brushed her teeth, lifted her in and out of bed, insisted on her doing all her physio exercises. And gradually it became clear that it was working. Dora began to improve. The movement returned to her leg and right arm, her speech became more intelligible. She could manoeuvre herself around in her wheelchair and ask for what she wanted instead of having to slur and point at things with her eyes. It was going to work. Despite all the doctor’s fears, Dora was going to manage at home.

  But Kevin was growing more and more irritated.

  ‘This is crazy,’ he complained when Dawn phoned, yet again, to say that she couldn’t make it up to London because Dora was running a chest infection. ‘Are we in a relationship or aren’t we?’

  Kevin. Dark, lively, football-mad. The man Dawn had once assumed she was going to marry.

  She had met him when she was twenty-nine, at a party in Judy’s boyfriend’s flat. The blokes from Andy’s Tuesday-night football team had been attempting to form a human pyramid on the kitchen table which had collapsed in a heap with Kevin at the bottom. He had landed in a funny way and done something to his wrist. Dawn, hustled urgently over by the panicking footballers to check it out, had covered it with a plastic Waitrose bag filled with ice. Kevin had made her laugh with some corny comment about needing to be hospitalized for the rise in his pulse. The following day they had met for lunch in Camden market. The week after that he had taken her to see Les Miserables and things had gone on from there.

  It had been a very happy time; Dawn still thought that even now. Lots of people about – not many of their friends had children then. There were parties, dinners, a skiing holiday for eighteen in Andorra. After a year, Dawn and Kevin decided to move in together. Dawn moved all her stuff to Kevin’s rented place near Waterloo, a one-bedroomed flat with a tiny garden on the roof. The flat was a short walk from the South Bank and the British Film Institute; a couple of tube stops from Oxford Street and the West End. On summer evenings they ate dinner on the roof where they could see the top of the London Eye revolving above the chimneys. Dawn would put her bare feet up on the sun-warmed wall and tell Kevin about the various funny or hair-raising experiences she’d had at work that day.

  ‘We couldn’t find Mr Cromwell’s dentures anywhere. Then the student suggested looking in the commode …’

  The topic of their buying a place arose. Inevitably, this led to arguments. Kevin wanted to stay in Central London. Dawn thought it might be nice to move out a bit where they could have a garden and escape the crowds at weekends. Details. Friends said, ‘You two will be married in no time.’ The thought made Dawn feel content and secure. She and Kevin were good together. They enjoyed doing the same things – going for winter walks along the Regent’s Canal or summer strolls by the Thames at Richmond. Eating out at Indian and Lebanese restaurants – which Kevin particularly liked because you could order a whole selection of dishes instead of having to settle for just one.

  Occasionally Kevin could be moody.

  ‘Thank God that’s over,’ he grumbled one evening on the way home from a drink with Dawn’s nursing friends. ‘Can’t you lot talk about anything but patients and hospitals and diseases?’

  ‘Of course we can.’

  ‘Well then, why don’t you? I’ve been sat there for the last three hours listening to Michelle describing the colour of someone’s leg ulcer and your other mate Judy bleat on and on about the time she nearly got two types of antibiotic mixed up. I don’t mind saying it, Dawn, I was bored out of my bloody mind.’

  The harshness of the attack surprised her. ‘That’s not all we talk about.’

  ‘It is all you talk about. And you’re the worst of the lot. No matter where we are or what we’re doing, you’re constantly distracted, wondering whether some bloke’s constipation has cleared up or whether some old codger you’ve treated is going to survive. A part of you is always there on that ward. You’re obsessed, Dawn. I’m telling you, it’s not normal.’

  ‘Obsessed’ was a bit strong, Dawn thought. But she tried to see his point of view. Medics were notorious for talking shop. It was why they often ended up marrying each other – because they bored outsiders to dribble with their endless hospital anecdotes: ‘So I said to myself, what about putting it in the left nostril, and then …’ But it was fair to say that Kevin didn’t go on all the time about his job as a quantity surveyor. So she made an effort to tone things down, kept her work tales for work and stuck to other topics when she was with Kevin. Apart from that – and you could hardly call it an issue – things ran smoothly between them.

  Once or twice, one tiny niggle occurred to her. Nothing she would have mentioned to anyone because it would have made her sound like one of those neurotic women who thinks that life should be like a fairy tale. It had come to her one evening as she was on her way home from watching some cheesy romantic blockbuster at Judy’s. Sitting on the illuminated bus, she had seen her own serious, oval face gazing back at her from the window, and what she thought was: Kevin never looks at me.

  Of course, he looked at her. He looked at her every time she spoke to him, brushed past him in the tiny flat, passed him something while he was eating, reading, watching TV. But he didn’t look at her. Not the way the hero had looked at the heroine in the film.

  Then her normal, sensible self intervened. Real life was not a cheesy film. Men did not – after the first few weeks, at least – spend their time gazing deeply into women’s eyes. She and Kevin got on well, they were good friends, they cared about each other and looked out for each other. And in a proper, long-term relationship, those were the things that mattered.

  The Friday she came home from work early to surprise him was a warm August afternoon. The temperature on the deep, crowded Northern Line had soared to over thirty-five degrees. Dawn’s uniform had stuck to her back and legs, making her skin itch. It was a relief to get off at London Bridge and feel the cool breeze from the river. She had spent the journey planning the evening ahead. She would have Kevin’s favourite dinner ready for him when he finished work.

  He was right; these past few months she had been neglecting him. She’d been torn between him and Dora, and Dora had won because she was the one who needed Dawn more. Dawn had been spending most of her nights at Crocus Road, and even the nights she had stayed in London she’d had to get up early the next morning to leave for work. Kevin came home in the evenings to an empty flat, ate dinner on his own, sat by himself on Friday nights when everyone else was out in couples. No wonder he’d been out of sorts. But now, bit by bit, Dawn was going to start moving back. Dora was so much better these days. She got on brilliantly with her carers; she was able to manage in the house overnight with just Milly for company. The worst was over.

  Light-hearted, she went down the steps past Southwark Cathedral into Borough Market. She joined the crowds filing past barrows piled with mangos and tomatoes, braces of pheasant hanging on pillars, wooden barrels filled with spices and powders. The high-roofed sheds smelled of fish and cheeses, grilling meats, warm, herby bread. Dawn went from stall to stall, gathering the ingredients for her Moroccan buffet: fresh mint and coriander, new-baked flatbreads, a pot of home-made hummus. It was ten past five. The cobbled str
eets beyond the market were packed with tourists and City workers with their ties off, perched on high stools, resting wine glasses on the tops of barrels. Moist patches appeared on Dawn’s brown paper bag as she walked in the heat to her tall, narrow building, sandwiched in its crooked terrace. The hall was cool and dim. A pile of junk mail teetered on the shelf inside the door. Kevin’s bicycle was chained to the banister. He was home early. Dawn climbed the stairs to the second floor and stuck her key in the lock of flat three.

  Kevin was in the kitchen, sitting at the table with a girl she didn’t recognize. In front of them stood two wine glasses and a takeaway pizza box.

  Kevin leaped to his feet. ‘Dawn. Hi!’ He glanced from her to the girl and back again. ‘I thought you’d be at your gran’s. You said you’d be staying down there till tomorrow.’

  ‘Well … since it was such a nice evening …’ Dawn’s hands were slippery. Something in the paper bag had leaked. The girl sat at the table, dabbing her finger at the crumbs in the pizza box.

  ‘Sister of a mate, just passing,’ Kevin explained.

  The girl smiled. She gave Dawn a little wave. ‘Hi.’

  ‘Hi,’ Dawn said.

  The girl seemed nice. Friendly. She had streaked, blonde-brown hair to her shoulders. She was maybe five or six years younger than Dawn. Dawn stared at her smooth golden skin, her low-cut green dress with the tiny yellow shoulder straps. Beside her, Kevin was staring as well, gazing directly at the girl, the way men looked at women in films. And Dawn knew there and then, standing with the leaking brown bag in her arms, that she had lost him.

  She moved all her stuff back to Silham Vale and busied herself full-time with Dora. She researched mobility programmes, speech therapy, new physio techniques and did all the exercises with Dora over and over. ‘I’ve never seen such progress,’ Dr Barnes, their GP, said in amazement. ‘She’ll be walking by Christmas.’

  But then the second, bigger stroke happened, and she never did.