Clinical Judgements

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Clinical Judgements Page 13

by Claire Rayner


  He leaned forwards then. ‘Even those who don’t actually live on the patch like all of you, but who are patients in the hospital all the same, would be able to see you from there, you know. The male medical ward — the one with the cardiac beds in it — it used to be called Cloudesely, do you remember? When your father was a patient in there —’

  She grinned suddenly, and that made her whole face light up. ‘I didn’t think you’d remember.’

  ‘I remember all my patients,’ he said. ‘He was a very brave man.’

  ‘Yes,’ she said and then grinned again. ‘Wicked old bugger. Drove the nurses there potty, he did, before he died. Old bugger —’

  ‘Yes,’ Professor Levy said and then added with a casual air, ‘He was at the far end of the ward, wasn’t he? In the corner where the double windows are?’

  She shook her head. ‘Imagine you remembering him so well! But, no. He was at the end near the nurses’ station. It was the only place in the ward they could be sure to keep an eye on him and stop him getting out of bed and wandering about.’

  ‘Ah — I’d forgotten that. I just thought he might have had the same bed as the one the Minister now has —’

  ‘The Minister,’ she said slowly and then sat up very straight. ‘He’s in the Male Medical ward, at the end there? Where you can look out over the yard?’

  ‘Yes,’ Professor Levy said. ‘Yes, I believe he is.’

  ‘I knew he was here at Old East. Saw it in the news. But I didn’t realise —’ Now a look of seraphic delight spread over her face. ‘So if we set out pickets there by the Medical School, he’ll see ’em?’

  ‘He’d be hard put to it not to,’ Professor Levy murmured. ‘And if he doesn’t happen to notice, well I dare say someone will draw his attention to you. I’d make sure the placards were large and clear, if I were you.’

  ‘Mr Herne’ll be right pissed off!’ someone said from the back of the group. They had been happy to leave it all to their fierce spokesman so far but as they at last understood what was being suggested, they relaxed and felt better able to join in. And now several of them laughed.

  ‘I dare say,’ Professor Levy said. ‘But as I said before, I’m really not responsible for any aspect of Mr Herne’s department and its work. Or its feelings.’ And this time he laughed too.

  Oliver was starting to get irritable. He’d been shoved from office to office, room to room and was getting nowhere. It was enough to force a man to be devious, and he hated being that. It had never been his journalistic style to snoop and pick up information illicitly. He’d always preferred to march straight in and announce himself, his job and his employers: ‘Merrall of City Radio,’ he’d said to them all, and what had it done for him? A freezing of the faces was all he’d got, a scuttling away to consult unseen seniors, a suggestion that he go to see Mr X here, or Mr Y there. But never any information.

  So it would have to be subterfuge, like it or not. He couldn’t just go up to the ward to ask, of course. He’d considered that, seeing the signs that said ‘Urology’, and had almost gone marching up there directly. But then he’d remembered that Esther was the sister in charge, and had quailed, because where Esther was, Kate could be. Even though he knew she was operating this afternoon, there was always the risk she’d come up between cases and see him there and though he could not for the life of him have explained why the thought of that was so dreadful, it was. He’d have to get his information elsewhere.

  He was making his way back from the Admin block where he had found so little help, on his way to the main courtyard to see if he’d get anywhere chatting up the gate porter — the sort of person who in his experience was often pregnant with information and willing to part with it — when he passed the Admissions office. And, on an impulse, went in, slinging his Uher in its case well back on his hip, so that it would be less visible to the people in there. Not that most people realised what it meant to be carrying that sort of tape recorder; but still, it paid to be cautious.

  The woman behind the desk peered up at him myopically and he smiled at her in the most winning way he could, and put on the Scottish accent he used on such occasions to make sure he disguised his all too recognisable voice.

  ‘Ah, I’m sorry to bother you, but I’m wondering if you could give me some information? For my old uncle, you know. He’s very distressed, you understand, and as he’s so old I said I’d come along and make enquiries for him.’ And he gave her the most charming smile in his repertoire.

  She seemed unimpressed. ‘We can’t give no details about inpatients,’ she said stolidly. ‘Got to ask on the ward. Sister’ll tell you.’

  ‘Ah, but that’s the point of it,’ he said, still with the charming smile well to the fore. ‘He’s not in yet. He was supposed to be, was all ready to leave the house and that but he got a phone call, from this office, I think, telling him the bed wasn’t available. Needed for an emergency —’

  ‘It happens,’ the woman said. ‘We are very busy here at Old East,’ and she looked at him reprovingly as though she personally were responsible for all the patients’ care, and was having her time wasted frivolously.

  ‘Well, I just wanted to check, do you see. Poor old Nunk — so upset he was, didn’t take it all in properly. Can’t remember, he says, whether you told him another date or not. Would it be asking too much for you to look it up for me, so I can tell him? He’s Ted Scribner, 17 Juniper Street. He was to have some sort of operation on his — you know — his waterworks.’

  ‘Bladder Daddy,’ the woman said loudly and stared at him for another moment or two, and then at last, reached for the keys of the VDU on her desk.

  ‘That’s very kind of you,’ he said fervently as she began to tap on the keys. ‘Scribner, it is. S.C.R.I.B.N.E.R. —’

  ‘It’d help more if you had his number,’ she said and sniffed unappetisingly. ‘But if he’s here I’ll find him — here we are. Under the care of Mr Le Queux, yes — due for admission for prostatectomy March 16th — then May 25th — and then —’ She stared hard at her screen, her lips moving slowly. ‘Yes, cancelled five times, he’s been —’

  ‘Five times!’ Oliver’s accent slid away from him as he stared at her. ‘He didn’t tell me that, for God’s sake —’

  She looked at him sharply. ‘Who did you say you were?’

  Just in time he reinserted Ayrshire into his voice. ‘Nephew — poor old Nunky! He only told me the last time was cancelled. Never said that — dear me, poor old chap. No wonder he’s so miserable —’

  ‘Well, it happens a lot.’ She hit a last key on the board and the dancing blue letters on the VDU vanished with a dispirited blip. ‘I’ve got people here in these records who’ve been sent for and then told not to come over ten times. Into double figures they are.’ She shook her head with melancholy pride. ‘Double figures. So five times — well, it happens.’

  ‘Can you give me any idea how long he’ll have to wait for the next offer of a bed?’

  She pursed her lips in genuine disapproval. ‘It’d be more’n my job’s worth to say a word on that. We can’t make no promises and so we’ve been told over and over. Mr Heme himself came down special and told us, no promises, no matter what. There’s such a shortage of beds, you see. They keep doing these cuts and then where are you? Just as busy as ever only worse off. There’s seventeen beds shut up over on Women’s Surgical you know, already. Got no nurses, they say. And now Mr Heme sends round this memo saying there’s likely to be more closures yet. So it’d be more’n my job’s worth —’

  ‘Yes, of course,’ Oliver said. ‘I can see that. Um — you’ve no way of knowing what sort of emergency it was that lost poor old Nunk his bed?’

  She turned the corners of her lips downwards. ‘How can I say? They’re coming in all the time to Urology. Kidney failures and all like that. Not for me to say, more’n my —’

  ‘Yes,’ Oliver said savagely, suddenly pushed beyond patience. ‘More’n your job’s worth. I quite understand — you oug
ht to get the record sometime, you know. It’s a funny song. Or supposed to be.’ And he left her staring after him with her mouth partly open, and slammed the door behind him.

  So now what? Go to Admin again and insist on seeing this chap Heme? He’d managed to be as slippery as a streak of slime all afternoon so far; no reason to suppose he’d be any more accessible now. Go and get Scribner’s side of the story in more detail then? An old voice on tape complaining about how he’d suffered — that would be powerful — then come back here and play it to the man Heme. Surely he’d get a response then? Clearly the old man hadn’t been just another crank. There was a story here, and it was worth getting at.

  And suddenly he brightened as the excitement of getting going on the research for a story at last lifted in him. It had been so long since he’d done this sort of investigation, that was the trouble. He’d been a star front man far too long. His original journalist’s fire had dimmed, settled to a dismal low glow, so that he’d forgotten just how tough you had to be, how determined, and how adroit at getting under people’s guards so that they parted with the information you needed out of sheer exhaustion.

  Get hold of Ted Scribner then, that was the thing to do, and use a recording of his voice to get to the faceless ones. And at the same time, talk to Radlett, see if he couldn’t set up a full investigation into what was happening here under an umbrella title that would look and sound good on the ads for the station. The NHS: are we at the crossroads? would be Radlett’s suggestion, of course. It always was, whatever the subject. Oliver would have to think of something a little sharper than that. The Unkindest Cuts of All, perhaps? Or something very plain and gutsy — Ted’s Operation. Simple, very direct — that might work —

  He was whistling softly between his teeth as he left Old East and headed towards the Highway and Juniper Street. It was amazing how being busy took your mind off your personal problems. Thank God for work.

  Audrey, standing in the window beside Joe’s bed and watching the traffic in the courtyard below, tried very hard to concentrate on what she was looking at. Three nurses hurrying across with their silken black legs flashing in the sunshine, obviously off duty and hurrying to change. So young and so happy looking; it must be wonderful to feel like them, to be so sure of everything, so comfortable with their own healthy bodies, and she moved her aching shoulders stiffly and stretched her neck and heard the crackle of rheumatism there and slid her eyes away to the people coming in and out of the A and E department. People on crutches and with bandages, and in wheelchairs; at least she wasn’t like them. She ought to be grateful for that, shouldn’t she? Sound in wind and limb, just a bit stiff now and again. Ought to be grateful.

  She turned back from the window and sat down again beside Joe. Grateful for what? she asked herself as she looked at his parchment-yellow face and the line of white crusting around his lips. She’d have to do something about that when he woke up; couldn’t let him get sore lips and a foul tongue again like last time. Oh, Joe, don’t do this to me! The words lifted inside her head with all the insistence of a silly popular song, and repeated themselves over and over again, unstoppable and uncontrollable. Joe, don’t do this to me, Joe, don’t do this to me, Joe, don’t do this to me — and abruptly she got up and went padding away down the ward to the nurses’ station.

  ‘He’s asleep,’ she said baldly. ‘I can’t just sit and watch him. Anything I can do?’

  Sister Sheward looked up at her from the notes she’d been writing and gazed at her blankly. ‘Hmm? Oh, Mrs Slater. Yes — well, that’s very kind of you, but I’m not that —’

  ‘There must be something,’ Audrey said and Sister looked at her again and saw the desperation there and put down her pen and smiled.

  ‘Yes, of course, Mrs Slater. There is, I’m sure there is. We’re so busy, you see, I can’t always stop to think — but let me see —’ She looked over Audrey’s shoulder down the ward and then brightened. ‘I could use Genevieve to help the nurses with the beds at the far end,’ she said, ‘if you’d take over her tea trolley.’

  ‘Lovely,’ Audrey said gruffly, and managed a small smile in return. A good old sort, Sister Sheward. You didn’t have to explain everything to her. ‘Just lead me to it. I’ll get it done in no time. Anyone not supposed to have any?’

  ‘The list’s on the trolley,’ Sister Sheward said gratefully. ‘If only everyone were as sensible as you! If ever you want a job on my staff, just say the word —’

  ‘I might need it sooner than — oh, well,’ Audrey said and moved away towards the trolley, but Sister pulled her back.

  ‘Would it help to talk about it?’ she asked quietly and Audrey stared at her with her eyes blank with misery and shrugged.

  ‘What difference does talking make? He’s not going to respond, is he? He did last time — a bit anyway. This time he just gets yellower and yellower and his breathing … it’s awful. How on earth am I going to manage him at home like that? The doctor’s already said he can’t stay here after he’s had his chemo, and it’s not working. So what’s there to talk about? It’s all a lot of —’

  ‘The way you feel, perhaps?’

  ‘You sound like those people on the telly, on the news, when there’s been a disaster. There’s someone just been blown up or found out their kids have been killed and someone shoves a microphone at them and says, “How do you feel?” How do you expect me to feel?’

  ‘Angry,’ Sister Sheward said after a moment. ‘Resentful. Guilty. Frightened. People do, when someone they love is dying.’

  ‘Angry —’ Audrey said. And swallowed. ‘How can a person be angry? There’s nothing you can be angry about. Not really — it’s the other things — I mean, being frightened. Yes. I’m frightened all the time.’

  ‘Of course you are. And angry.’

  Audrey shrugged and began to fiddle with the cups on the trolley as Genevieve, the West Indian orderly, went over to help the bedmaking nurses, in response to a little jerk of Sister’s head. Thank God for Genevieve, Sister thought; quick to pick up what’s going on and with the wit to act on it. Thank God for Genevieve. ‘No sense in that,’ Audrey said. ‘Being angry —’

  ‘A lot of people get most angry with the person who’s dying,’ Sister Sheward said carefully, and tried not to look at her watch to see how much time she had left to get the notes finished before the afternoon shift arrived to take over. She’d never get away on time tonight, that was for sure, and David with tickets for the Barbican too. But she didn’t move from the trolley, and watched Audrey as she set out the cups and began to pour in the milk.

  ‘Not me,’ Audrey said in a muffled voice. ‘I couldn’t be angry with my Joe. He’s — it’s not his fault if he’s like this. How could I be angry with him?’

  ‘Well, some people are. I just thought I’d mention it,’ Sister said. ‘In case it happened to you and you felt bad about it. Don’t. As I said, it happens to a lot of people. Now, I’ll let you get on, and thanks for your help. They’re dying for a cuppa, these chaps of mine —’

  And Audrey got on, pouring tea industriously, checking each bed number off against the list on her trolley for permission to give out the thick brew, and concentrated entirely on her work.

  Until she got to the end of the ward, where some of the beds had been taken out. No one had told her not to go into that section of the ward, and she hesitated for a moment. She knew who was there, of course. Everyone in the ward did and had watched with eyes that missed nothing the busy traffic of secretaries and very obvious plainclothes detectives and messengers with heavy files that went in an unceasing stream to and from the end section. The Minister for Health, she thought now, and looked back over her shoulder to where her Joe lay, barely breathing in his sleep, and tried to see him at home, in their little house with the tiny rooms, tried to see herself coping, tried to see Joe getting the care he ought to have —

  And with a sharp little movement, she seized her trolley and pushed it, cups rattling loudly, into the en
d section where usually four patients lay but where at present there was only one.

  Chapter Twelve

  ‘Well, I say it’s a matter for the Ethics Committee,’ Goodman Lemon said, ‘and I can’t help it if they aren’t supposed to meet for another fortnight. I want a decision as soon as possible. They’ll have to be told to meet now. As a senior member of the consultant medical staff, I’m entitled to demand that, and so I do.’

  ‘And will it make the slightest difference what they say, Lemon? Even if that were possible, which it isn’t,’ Professor Levy said wearily. ‘It’s clear to me you’ve made up your mind about this, and nothing I say will have any effect. So why should the Ethics Committee affect you?’

  Goodman Lemon stared at him and then got to his feet and went over to the window to stare down into the courtyard. ‘Look at them!’ he said. ‘A lot of rabble — you ought to get the police on to them; Heme ought to. It’s all the same these days — no one’s got any respect for the decencies.’

  ‘They have just complaints,’ Levy said. ‘And I’d rather people made their feelings clear and tried to take an interest in what happens to them and to their hospital than just lie supine under events. As I say, people should listen to others —’

  ‘Listen to creatures like those?’ Lemon snapped and turned back from the window. ‘Listen to people like this disgusting man Slattery who has the brass neck to come here begging our help and then refuses to accept our perfectly reasonable caveats? It’s you damned do-gooders and your ridiculous ideas that led to this. You did all you could to ruin this country and left us with all these disgusting problems!’ He stood there with every inch of his thin body seeming to vibrate with the intensity of what he was saying but looking really rather ridiculous. His sparse grey hair was carefully trained over a bald head, and his scrawny neck peered out of his collar at an awkward poking angle so that he looked sadly like a tortoise, an impression considerably increased by the heavy lining of his face. ‘If it hadn’t been for all the freedom these creatures were given in the first place we wouldn’t have to deal with this dreadful disease now.’

 

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