Clinical Judgements

by Claire Rayner

  Sian had bristled. ‘I’m not a scab. I don’t do other people’s work just because —’

  ‘Matter-of-life-and-death,’ the staff nurse said in a gabble, and showed her a tight-lipped smile. ‘I’m as much involved with the politics of this place as you are, my friend, and I can tell you that if you refuse on such grounds I can make all sorts of problems for you because having the dialysis machine ready for the next patient that needs it is life-and-death stuff, as you’d know if you’d been on this ward a little longer than five bloody minutes. So are you going to do it, or do I have to send you to be disciplined? Sister’d back me and the Union won’t step in for you, believe me. Not on this sort of issue. They’ve got more bloody sense and it’s time you got some too. Stirring up that woman like that — I could have killed you —’

  So, Sian went to clean the machine, and took as long over it as she dared. She’d show that bitch where she got off, she thought furiously as she sluiced the tubes through in their special lotion. She’d show her —

  It was a little while before she realised that Kim and her visitor had forgotten she was there, and had stopped talking in the low tones they had started with. Sian had drawn the curtains to do her job, partly to give Kim privacy but mostly to hide herself and her ignominy out of sight. If the other nurses came by and saw her they’d know what had happened and no one, least of all Sian, would want that. So there she had been for over half an hour now, fiddling with that damned machine, and Kim and her visitor were talking.

  Listening to other people’s conversations had always been to Sian something that was natural and perfectly reasonable. She had never understood the embarrassment some people showed when they were inadvertent eavesdroppers, and had said as much, often; and indeed had often been a deliberate eavesdropper. It was usually the quickest, simplest way of finding out what was going on, and knowing what was going on was lifeblood to Sian. Well, she would say reasonably enough to anyone who would hear her, isn’t it to everyone?

  So, now she listened with all the concentration she had, and felt herself get more and more angry as she did so. Not with Kim, though from the start she had disliked him. To see him make such a display of himself was disgusting to Sian, who anyway regarded with disdain any woman who wore red nail varnish and who curled and dyed her hair, and she had consistently refused to say anything but ‘he’ and ‘him’ when she spoke of the patient in bed seventeen. As far as Sian was concerned Kim Hynes wasn’t much of a man and was certainly no woman; she would loathe any woman who looked like that and to see a man deliberately ape such style — Sian had actually shuddered. But now, listening to the smooth tones of the man beside Kim’s bed Sian bristled even more. At him.

  Bloody robber, she thought as she rubbed at the chrome of the dialysis machine. Bloody man, making even more of a fool out of that idiot. It’s all wrong; I’ve got to stop him. And then the curtains billowed and there was the scrape of chair legs on the floor as the man stood up and prepared to leave.

  Sian thought for a moment and then, as the man began a convoluted ‘Goodbye’, straightened her back and, moving swiftly, went across to pull back the curtains. Looking at the man, she felt obscurely, would be the first step to dealing with him and as the curtains rattled on their rail she looked sharply from one to the other of the two startled faces on the other side.

  ‘I’m sorry, Kim,’ she said brightly as Kim stared back at her. ‘Did I disturb you?’

  ‘Not at all,’ the man said smoothly and smiled at her and Sian shifted her gaze to him. Small and rumpled was the first impression she got of him. And then saw a round face crowned with a fast receding hairline behind which grew a fringe of very dark hair and the somewhat overcoloured cheeks of the heavy drinker. But he was in fact quite young despite that collection of attributes; not much over thirty-five, she hazarded. And then he grinned at her and looked even younger.

  ‘I was just saying goodbye,’ he said. ‘I imagine visiting time’s almost over.’

  ‘There aren’t set times exactly,’ she said and looked back at him pugnaciously. ‘Not for relatives. Are you a relative of Kim’s then?’

  ‘Just a friend,’ the man said easily and grinned again. It really was quite a friendly face, Sian thought, and began to feel a little less angry. ‘Everyone needs friends. Better than family, sometimes, eh Kim? Friends you choose, family you get lumbered with.’

  ‘Ooh, original, isn’t he, Nurse?’ Kim said and glittered at Sian and Sian looked at that smooth painted face and then flicked her eyes back to the man now standing at the foot of the bed.

  ‘I’ll show you the way out,’ she said abruptly. ‘As you’re going.’ And moved forwards purposefully so that the man had to follow her.

  ‘I’ll be in touch, then, Kim,’ he said over his shoulder and then followed Sian down the ward towards the double doors at the far end.

  She turned on him with a combative stare as they went through them and could no longer be seen by Kim, who had been staring down the ward after them. Sian had been able to feel those heavily mascaraed eyes on her back, so intense had been the stare.

  ‘Listen, mister,’ she said in a low voice. ‘I don’t know what you think you’re up to, but if you make trouble for any patients here, whoever they are, we won’t put up with it.’

  He looked down at her, amused, and his face wrinkled into a wide grin. ‘Who won’t?’

  ‘I won’t for a start,’ she said fiercely. ‘That poor devil — how long have you know him?’

  ‘Never met her before today,’ the man said smoothly and grinned even more widely.

  ‘I didn’t think you had. Then what are you up to? Who tipped you off?’

  ‘What I’m up to is nothing that’s bad, nothing that’s illegal, and nothing that’s any of your damned business,’ he said, still equable, and still grinning at her. ‘As for who tipped me off — bless you child, she did.’

  ‘Don’t call me child, you great — you —’ she spluttered and then took a sharp little breath in through her nose. ‘Don’t you bloody patronise me, mister. I don’t go for it. It might do for you old-timers, but me, I’m a today person, know what I mean? So none of your nonsense with me. Our patients are here to be looked after, whatever they’re like, and we don’t want you newspaper people sneaking around after them —’

  ‘Clever girl, got me in one,’ he said approvingly. ‘Not that it was difficult, I imagine. Seeing I was running an interview there —’

  ‘And if you start any trouble for that poor devil I’ll —’

  ‘What will you do?’ he said and she had faltered for a moment.

  ‘I can alert the necessary authorities,’ she said with all the dignity she could muster. ‘There are ways of keeping you people out of here.’

  ‘Now why should you want to?’ he said, and leaned his back against the wall, settling down for a long conversation, his hands thrust deeply into his trouser pockets. ‘Aren’t we the free press, one of the bulwarks against injustice?’

  ‘Oh, sure,’ she said scathingly. ‘So you lot say. Though what sort of bulwark you can build out of boobs and bums all over page three is anyone’s guess.’

  ‘Oh, that’s what you get in the comics,’ he said, still very relaxed and comfortable. ‘Not on a real paper. I’m on the Globe. We’re a paper — no tits and ass here. Sounds better in American, doesn’t it? Not so cheap —’

  ‘It’s cheap wherever it is. And you’re just as bad as the people who do it —’

  ‘Now let’s stop all this, shall we?’ Still he looked as urbane as ever, but there was a little edge to his voice now. ‘This is getting just a shade boring. So I’ll put you straight, hmm? I got a letter from your patient Kim Hynes. She was asking for money. Says she’ll TELL ALL, in capital letters, if we pay her enough. Pictures, grisly details, the whole bit. So, like any reasonable journalist, I came along to find out. Now you tell me: just how wicked is that? Where is the boobs and bums sinfulness in that? We haven’t even published it yet. All I’
ve done is listen to a sad tale of woe, and that’s the end of it. Or it might be. The way you’re going on makes me begin to wonder if there’s more to this than meets the eye. You seem to dislike the woman from all you say. Very protective and all that, but you don’t seem to like her much — keep calling her a poor devil —’

  ‘He agreed to sell it to you, this story?’ She stared at him, her forehead crumpled with disgust. ‘Actually offered to sell to you for money? Ye gods, what a shit!’

  ‘I said you didn’t like her —’

  ‘Her my — my left foot,’ Sian said and reddened. ‘That’s a man, with a lot of mad ideas about what women are like. No woman would be so bloody daft —’

  ‘My, but you’re an intolerant little madam, aren’t you? And I thought nurses were so sweet and understanding. Just shows how wrong you can be, doesn’t it? Would it amaze you to know that there have been women in poor old Kim’s situation? That women have had sex-change operations? Swallowed hormones to grow themselves beards and give themselves basso profundo voices? Because they have. I know one who went to the Human Rights court in Strasbourg over it —’

  ‘Oh, what’s that got to do with anything?’ She was angry again now, and eaten with the embarrassment of having made a fool of herself. ‘I still reckon it’s a dirty thing to publish stuff like that for money and —’

  He shrugged. ‘People have to make their livings the best way they can. Kim Hynes lost her job because of the situation she’s in and she’s doing all she can to get enough to start her own business. I’d have thought that was admirable, not a cause for this sort of reaction. But there, we of the press are maybe a little more open-minded than you handmaidens of Hippocrates.’

  ‘Well, I don’t just care about one patient,’ Sian flared at him, her face red now with the confusion of feelings that filled her. ‘There are others, you know, who get the dirty end of the stick because of the likes of Kim Hynes —’

  ‘Oh?’ He was still leaning negligently against the wall but seemed to have gone tight with interest. ‘How do you mean?’

  ‘Well, waiting lists and so forth —’ She stared at him and seemed suddenly to realise how indiscreet she was being. ‘Oh, it doesn’t matter. And it’s none of your damned business anyway! Just keep out of my way, do me a favour. And if you come back here, watch out, because I’ll tell Sister what’s going on and she won’t be a bit pleased. They don’t like journalists here —’

  ‘I’ll bet they don’t,’ he said. ‘Mind you, some of the people who use the place do. I saw the demo going on outside. I’m covering that too, seeing I’m here, so I suppose you object to that as well.’

  ‘Don’t you sneer at me! I most certainly do not object! I agree with them totally. It’s all wrong what they’re trying to do — close this place down. They have to be mad. It’s all part of this bloody government’s policy of course — make the NHS a second-class service and turn all the hospitals into workhouses while the private set-ups make a bloody fortune out of those who are forced to pay — it makes you sick. Of course I agree with the demo —’

  ‘Then you want the publicity, I imagine. Even in a boobs and bum paper? Not that we are at the Globe, of course —’

  ‘Oh, blast you,’ she said after a moment, and then, to her own amazement, laughed. It all seemed so silly suddenly, and he grinned back at her, cheerfully.

  ‘Attagirl,’ he said. ‘Seen the light at last. Listen, when do you get off duty?’

  ‘None of your business,’ she said, on safe ground again now. Men who wanted to chat her up she understood and could handle. Men who sneered just made her feel ready to burst with rage.

  ‘I can work it out,’ he said and looked at his watch. ‘It’s nearly seven now, so you’re on the middle shift. Off at nine, hmm? I saw the pub over the road — I’ll meet you there at half past, get a few in and we can talk about the evils of the Government and the way they treat the NHS and say how we’d do it better. And you can put me in my place over the Kim Hynes story. What do you say? Give you your chance to put the world right —’

  ‘I should cocoa! I can just see you printing what I’ve got to say, a junior nurse —’

  ‘Never you think it, my love, never you think it. I can get quotes from professors and high-up brass till they come out of my ears. It’s people like you, at the sharp end of the coal face where the nitty-gritty grows and the bottom line gets down to brass tacks that are really interesting. So, is it a date?’

  ‘Not if you talk that way,’ she said and turned to go back into the ward.

  ‘I promise you not a cliché shall sully these ruby lips,’ he said promptly. ‘Half past nine then.’

  ‘I’ll think about it,’ she said and disappeared into the ward, well pleased with herself. It would be quite fun finishing cleaning that bloody machine now, with something interesting to look forward to.

  Chapter Nineteen

  ‘You’ll be happy to know, I’m sure, that your cystoscopy findings are clear,’ Kate said and smiled down at Gerald Slattery. He was sitting up in bed very neatly, foursquare against his tidy pile of pillows in red-striped pyjamas carefully buttoned to the throat, and with his thin hair combed over his shining pink scalp equally neatly.

  ‘I didn’t think they’d be otherwise, to tell the truth,’ he said. ‘Seeing I hadn’t had any problems with the plumbing. I told you I didn’t — and I told that lovely black doctor — I still don’t know why I had to go through with that. Not for a hernia. It’s all been explained to me, you see.’

  She avoided looking directly at him, keeping her eyes on his chart. ‘We just thought it as well to be absolutely sure,’ she said. ‘How are you feeling this morning?’

  ‘Sore,’ he said. ‘This lump’s like a billiard ball where no one should have to have a billiard ball. And I can’t pretend I’m not getting worried about it.’

  ‘We’re going to deal with it,’ she said. ‘I’ve listed you for surgery tomorrow morning. Is that all right with you?’

  ‘Couldn’t be better. At last. Anything’s better than sitting round here waiting. It’s like being in prison and expecting the chaplain to turn up any moment to let you know that the executioner’s getting restless. Why the delay, if I may be so bold as to ask?’

  Now she did look at him, consideringly. So far all the discussion about the pros and cons of this man’s operation had been between herself and Professor Levy and whoever else he might have chosen to talk to. Kate had deliberately not asked him about Goodman Lemon’s reaction to the way Levy had scooped this patient out of his ward and got him transferred to hers. She had enough to deal with with her own work without deliberately getting involved in the intricacies of hospital politics any more than she had to. But she was well aware of what was likely to happen when Lemon found out what had been done, and wasn’t the patient, too, entitled to know? He looked back at her with bright, rather protuberant pale blue eyes, and she saw the intelligence there and the watchfulness and made up her mind quickly.

  ‘Do you realise you’ve caused rather a fuss?’ she said abruptly.

  ‘Oh? In what way?’

  ‘You refused some blood testing.’

  ‘Ah, yes. I thought that perhaps — well, I’m entitled to refuse, aren’t I? I’m not a fool you know, and I’ve eyes in my head and I can read. I’ve followed the arguments you doctors have been having. There’s one lot leaping about saying they reckon they’ve the right to do secret blood tests on us without our consents, and the other lot saying it’s unethical. Me, I agree with the other lot. But then —’ He looked up at her with his chin tilted a little and laughed. ‘As the tart said, I would, wouldn’t I?’

  ‘Would you?’

  ‘Oh, Doctor, please! I gave you credit for being — well, really! I mean, just look at me! Of course I’d refuse! Of course I did, come to that.’

  ‘Just what are you refusing?’

  ‘Oh, come on, Doctor! Don’t treat me like a baby! I thought better of you, I really did.’

&
nbsp; ‘I’m not trying to treat you in any way but what is best for you, truly, Mr Slattery. I just think we’ll get on better if we understand one another fully. And we can only do that if we talk directly and not in circles. Now, you tell me what it is you fear and I’ll tell you what the problems here have been. Fair enough?’

  He looked at her for a long considering moment and then nodded. ‘Fair enough,’ he said and then leaned over to scrabble in his bedside locker and pull out a writing case.

  ‘I’ll need my documents, won’t I? Right — here we are —’ and he brandished a newspaper clipping. ‘All right. You begin.’

  ‘No. You.’

  ‘Ooh, you do cheat. All right then, I’ve nothing to hide! Look, I’m gay. Homosexual, you know? And do note how I pronounce it — homo as in tommyrot, not homo, as in oh-dear-no. It means I fancy my own sort better than the other sort. Nothing against you, Doctor dear, you understand, it’s just the way I am. And my sort, God help us, have been struck by one of the bloodier plagues of Egypt and everyone’s having conniption fits. Not me, though. Me, I’ve got my old Stewart. We’ve been together for seventeen years, a right old married couple we are, never strayed, either of us. Couldn’t be doing with teaching someone new all our little ways, to tell you the truth of it. So, as I say, there we are. Nice, normal and married. Yes, normal! Don’t stand there looking as though you’ve been stuffed. In our terms we’re normal healthy ordinary chaps, with as much right to be camp as everyone else has to be boring. If we want to carry on like we live in pink tents, why shouldn’t we? It’s no crime —’

  ‘I really only want to talk about your treatment,’ Kate murmured. ‘Do we have to have the whole lecture?’

  ‘You told me to start first! Anyway, when all the fuss started we both agreed, Stewart and me, no tests. We aren’t at risk, we’re sure of that, and we know bloody well what’d happen if we do test and by some mad chance it turns out we’ve got a touch of the plague from before seventeen years ago. Who can say, after all? Better not knowing, that’s our motto. And then we saw all this stuff in the paper’ — and he waved the newspaper clipping in the air — ‘about how doctors may do secret tests and put them on computers and we both said not on your nelly, no tests if we get ill. Not without we know what they’re doing and why. And then, bugger me, if you’ll pardon the expression, there I go getting this hernia and what can I do but keep my word to Stewart? No testing. So now what? You tell me.’