Clinical Judgements

Home > Other > Clinical Judgements > Page 30
Clinical Judgements Page 30

by Claire Rayner


  ‘Well, yes, Sister. I just wanted to check we had enough because —’ She stopped, her lies in tangles around her feet and Sister, her eyes now accustomed to the gloom, scooped up the dressing towels, she had come in to fetch and then peered more closely at Suba’s streaked face.

  ‘Tears? Oh, for heaven’s sake, girl! What is it now? What’s upset you?’

  ‘Nothing, Sister,’ Suba managed to gulp and then to her horror the tears began to flow again, for Sister had sounded sharp but not entirely unsympathetic, and that seemed to have pulled the stopper out of her.

  ‘Well, we’ll get nowhere steaming up in here,’ Sister said in a resigned sort of way. ‘Out you come, my girl, and into my office and then we’ll see what all this is about —’

  ‘It’s personal, Sister,’ Suba managed, clutching at the first thought that came into her head to free her from any need to tell Sister Morgan what was upsetting her. ‘It’s just personal —’

  ‘Hmmph,’ Sister Morgan said and shepherded her out of the linen cupboard into the comparative glare of the corridor outside. ‘Well, if you say so, you say so. But you’ve no right to be sitting around being personal on my ward and in my time. I’ve all these patients to look after and no time to waste on any of your fusses! And look at you, girl! I can’t let you be around the patients looking like that. Come along into my office and you can do my filing for me. That’ll keep you out of trouble till you’ve regained a little common sense. But first wash your face and make yourself look respectable and then come along to me.’ And she gave her a little push with a not unfriendly hand and, somewhat comforted, Suba obeyed.

  At least she hadn’t had to blurt it all out. Sister Morgan, she was quite sure, would be deeply lacking in any sympathy for what she had done. She could remember all too well what had happened the first time she had tried to explain how worried she was about Mrs Walton and taking her to theatre. And she felt the tears tighten her throat again as she remembered the way Mrs Walton had clutched at her hand in the theatres that day, when she had been sliding woozily under the anaesthetic, and how glad Suba had been that she could make her feel a bit better —

  The cold water she splashed on her face helped a bit, and she was able to come back to Sister’s office in a somewhat more composed state, and Sister saw her and nodded approvingly and indicated a chair in the corner and on the table in front of it a great pile of folders and an even higher pile of papers.

  ‘All these reports are just back and have to go into the notes,’ she said. ‘If you make any mistakes I’ll flay you alive, understand me? Make sure you staple the path reports to the path cards, and the X-ray reports to the X-ray cards — I don’t want ’em mixed up. And make sure the bacteriology reports with the red stars on the corners are clipped to the red bacteriology cards, you understand. Not the white one. Right? In any doubt ask me. I’d rather be pestered now than driven mad by stupid errors later on.’

  Gratefully Suba settled to her job. It was just what she needed, demanding concentration and attention to detail which would stop her thoughts running round in circles, but not so much that she’d get flustered. And after ten minutes of sorting and clipping she began to relax and feel that maybe it would be all right after all. Maybe she’d be able to forget all about what she’d done? She could be sure of one thing: she’d never do such a thing again.

  The door of the office opened and at first she didn’t look up, struggling as she was at the moment with a recalcitrant stapling machine, and then she heard the voice and almost froze.

  ‘Hello, Beverly. Have you seen the bloody evening paper? And I’m told it was even on the news on radio at three o’clock — I ask you! These stupid people! What am I supposed to do, ask the whole bloody country for a second opinion before I operate on any patient? Damned meddling fools —’

  ‘Tea?’ Sister Morgan said imperturbably and pushed her tray forwards as Miss Buckland almost threw herself into the other chair by her desk.

  ‘Thanks,’ Miss Buckland said and poured a cup and drank it thirstily. Suba sat and stared down at her sheets of paper, not sure what to do. Sister knew she was there, and for that matter so did Miss Buckland, for she was clearly visible. If they wanted to talk privately they’d say so, surely, and she’d be able to escape? And she coughed a little experimentally and Sister looked sharply over her shoulder and said, ‘Do get on, Nurse. I want those done tonight, not next week.’ And obediently Suba bent her head and began to shuffle the papers.

  Miss Buckland was the first to speak. ‘It’s so bloody stupid,’ she burst out suddenly. ‘The trouble with most of these people is they don’t really listen to me. I’ve turned up on a couple of TV programmes and expressed an opinion, so they decide on the basis of that to pin labels on me. Radical feminist, they’re saying in the news, you know that? Me! As dedicated a non-joiner and non-labeller as anyone can be, and I get that sort of nonsense shoved at me. If they’d just read what I’ve written and read it properly and listen to all I’ve actually said and not what they choose to hear, they’d know what I’m for. I’m for choice, God damn it. Every woman has the right to choose what’s right for her and her child. And to call me abortionist as though I cheerfully rip ’em out on demand — I never heard such —’

  ‘It’s no use getting so angry, Miss Buckland,’ Sister Morgan said soothingly. ‘Hundreds of people know it’s not true. I know it’s not true. If it comes to it you can always get me to stand up for you. I know what you are and how hard you work for women and babies, none better, for pity’s sake! And I’ll tell ’em — if I have to.’

  ‘I might have to ask you,’ Miss Buckland said gloomily. ‘They reckon it’ll come to court, you know. I told that bloody policeman there was no case to answer but he’s got hold of some documentation in the case — don’t ask me how, but he has. Several pages of Mrs Walton’s notes, I gather, including the ones where there’s discussion of the doubt about her dates. Do you remember? You thought she was about twenty-four weeks, and I said I didn’t think so, she was just small for her dates, because she was quite adamant about her last period —’

  Suba went on sorting the reports mechanically, having to read them over and over again to get any sense out of them. She knew exactly which page Miss Buckland meant: hadn’t they all made a particular point of that one and got all excited over it when she’d taken the pages into the meeting?

  ‘— and when we talked to Harry Holbeck for a second opinion he said he thought twenty-six weeks on the scan. Either way she had a rapidly growing carcinoma there with lymph node involvement and I know I was right to do what I did. And damn it, the woman wanted to abort anyway! Who are these bloody moralists who think they have the right to tell other people how to live their lives? Or die their deaths …’

  ‘It’s babies’ lives they go on about, Miss Buckland,’ Sister said and poured some more tea. ‘Going on about what the mothers want is what gets them going. They’re not interested in mothers. Only in babies —’

  ‘I’m interested in babies too, dammit! And God help anyone who says I’m not —’

  ‘And you’re also interested in a lot of things these people disapprove of. It’s no use getting mad about it, Miss Buckland, you know that! I know you’re labelled as a feminist — I think you are, come to that —’

  ‘And what’s wrong with being on the side of women?’ the other flared at her and Sister Morgan laughed and pushed her teacup nearer to her hand.

  ‘Not a thing. I’m just trying to be practical. Getting annoyed isn’t practical. Deciding what to do is. So what will you do? If it comes to court?’

  ‘What can I do? Turn up there and tell ’em they’re all bloody fools. What else is there?’

  ‘That’ll get you a long way,’ Sister said dryly. ‘I’d have thought it might be an idea to get some of the patients whose babies you’ve saved for ’em to turn out to support you. All those threatened abortions you do so well with. Then they’d find it harder to make the labels stick, wouldn’t they?�
��

  There was a little silence and Suba thought — Shall I tell her now? Beg her pardon? Ask how I can help? Maybe I could help, after doing all those bad things to her. Maybe I could make it a bit better —

  ‘I suppose that might help. My own solicitor was asking about that sort of thing — character witnesses. It’s just so sickening it should be necessary, for God’s sake!’ She seemed ready to burst with rage again. ‘After all these years — and I’ve given them all I’ve got, these women and their babies — to have to dig out character witnesses? It’s a bloody insult!’

  ‘Insult or not, it could be useful,’ Sister Morgan said. ‘Look, let’s think of some of the more recent patients we’ve had — what about —’ and she pulled her big ward ledger forwards and began to riffle the pages. ‘Let me see: who have we had these past few months? There are those children, Tracy and — no, they won’t do. You’ve made sure they’ll be able to have babies eventually but they’re really a dreadful little pair of tarts. They won’t make the right impression at all … Ah!’ And she stopped with one finger set on the page and looked up at Miss Buckland and grinned.

  ‘Well?’ Miss Buckland demanded and Suba had to hold on to the table in front of her to prevent herself from jumping up to go and look over Sister Morgan’s shoulder.

  ‘That girl Roberts — the one who went to a back-street abortionist and he perforated the Pouch of Douglas — you remember? She’s still pregnant and if you hadn’t been so quick and good she’d have lost the baby and herself as well probably. Bled like a — remember? She ended up having seventeen units of blood in the first couple of hours she was in. Now, if we can get her, then maybe — yes, I like it. She’d be the best possible character witness. What do you think?’

  ‘I don’t like it.’ Miss Buckland got to her feet. ‘In fact I hate it. I don’t look after people in a — on any sort of conditional basis. I don’t take care of ’em and then go and say, “Listen, I did this for you, now you come into court and help me out.” I won’t do it. It’s disgusting.’

  ‘It’d be a lot more disgusting if they win a case against you, Miss Buckland. And they could, you know. The way things are these days, people are very —’ She shrugged. ‘Intolerant. I still remember what happened to that paediatrician who was accused of killing Down’s babies. They put him through hell. And then he died soon after, heart attack — these are nasty times.’

  ‘Yes,’ Miss Buckland said and stood there with her hand on the doorknob. ‘I know. But I don’t have to make ’em worse by behaving as they do. I’m not asking any of my patients to come to court on my behalf. It’s not right, and I won’t do it. Look, can we go and see the Lester woman? Have you got the histology back on her D and C?’

  ‘I have,’ Sister said. ‘It’s here —’ She came over to the desk where Suba still sat with her head down over the reports. ‘Move over, Nurse. Let me see — now where was it — ah, here she is. Yes, I made a note to tell you. I’d have called you if you hadn’t come in. She’s got a CIN 3 just for openers, but there were some doubtful cells in the endometrium. They want to do a repeat. Unless you opt to do a hysterectomy anyway —’

  ‘I’ll talk to her,’ Miss Buckland said. ‘She might be willing. It’d certainly be safer, the speed with which some of these endometrials spread. It’s getting really virulent lately — or have I just been unlucky with some of my patients?’

  She sighed then and opened the door. ‘Do you remember the story about the little Dutch boy who was walking on the dyke one day and saw a little hole in it? Knew if it wasn’t dealt with the dyke’d break down and the whole of Holland’d be flooded? Well that’s me, I feel as though out there are millions of women all with rampant cancers of their genitals and I’m the poor cow with her thumb in the dyke trying to hold it all back. God, I’m tired. Come on, Sister. Let’s go and see who we can mutilate today, God help us —’

  Suba sat for a little while after they’d gone, watching them through the glass wall of Sister’s office and trying to think what to do. Miss Buckland might be a noisy person and she might swear more than Daddy would approve of and she might be rude to people sometimes, but that didn’t mean she was bad. Suba had done a terrible thing, taking those papers to that hateful group of Shirley’s. It was all Shirley’s fault, she thought then, letting resentment fill her with a warm and comforting wash. If it hadn’t been for her I’d never have done such a nasty thing. It was all her fault —

  But you did it. The thought slipped out from beneath her resentment to bob about on the surface of her mind and sharply she got to her feet and went over to Sister’s desk, where the ledger still lay invitingly open.

  She stood there for a moment looking down the ward as casually as she could. From behind the glass wall came the usual afternoon clatter of teacups and the ever-present drone of the TV set in the day room, and there was some laughter and chatter too, for many of the women were up and about. She could see Sister’s back, and beyond her on the other side of the bed they were standing beside, the rumpled head of Miss Buckland. Both seemed absorbed in what they were saying to the patient and unlikely to look over their shoulders at her, so slowly she bent her head and ran her finger down the column of names on the left-hand side of the page. And found it.

  Prue Roberts. Of course. She remembered Prue Roberts very well. She’d been very friendly with the woman in the next bed who’d tried so hard to get pregnant and who had told Suba all about it. Over and over again she’d told her. Prue Roberts. Yes, she was the person to help Miss Buckland. And if Miss Buckland wouldn’t ask her, then she, Suba Mahmoudi, most certainly would. Then maybe she’d feel better about the awful things she’d done to start the trouble in the first place. And then she wouldn’t have to give up nursing after all.

  She went back to the pile of reports waiting to be filed with the full name and address of Mrs Roberts carefully scribbled on a piece of paper and tucked into her waistband. She’d go and see her the first chance she got and see to it that she saved the day when Miss Buckland had to come to court. And it was really remarkable how much better Suba felt as she thought about it.

  Chapter Twenty-Seven

  There was always hubbub in the Accident and Emergency department but when Kate pushed open the great rubber doors to go in she felt the impact of the extra busyness of the place today almost as a direct physical blow. There were people everywhere; in the middle of the department a large, hairy and very noisy man in dirty jeans and tattered leather jacket was fighting with two of the young male student nurses and swearing at the top of his drunken voice; not far away a small child sat on its mother’s lap with its mouth wide open and bawling loudly as she sat and stared blankly at the fighting that was going on while making no effort to soothe him, and wherever else Kate looked there were people sitting drooping in bandages or with bruises or clutching various parts of their anatomies, to display their justification for being there waiting to be seen, as doctors and nurses bustled in and out of the curtained-off cubicles, clearly busy about even more damaged patients than the waiting crowd.

  She looked round hopefully as at last the shouting man was borne away by the triumphant young nurses and the baby stopped its crying, looking for Sister; and then saw two sizeable policemen standing in front of a corner cubicle. They were murmuring to each other and she looked at them, frowning. They couldn’t have anything to do with Oliver, surely? And she wondered briefly why the idea had even come into her mind. And then thought — Traffic accident? And walked even more quickly across the broad waiting room to Sister’s office.

  Sister was, to her relief, in there and greeted Kate with a wide smile. They had worked together many times when Kate had been senior surgical registrar, the job she had held before getting her consultancy, and they’d got on very well. It comforted Kate just for a moment to see her, and she managed a smile too. But it was a brief one.

  ‘Oliver Merrall, Mary? He’s in here? What’s happened?’

  ‘Then he isn’t just confused?
He kept on about wanting to see you and I thought maybe he was just — he wasn’t very rational, I must say. He does know you?’

  ‘Yes, he knows me,’ Kate said, trying not to let her impatient anxiety show. ‘What’s happened?’

  ‘I’m not sure. I gather he got into some sort of altercation out there on the demonstration. I’ve had a couple of other people in here to patch up, because a real fight got going. I’m told there were TV cameras out there, the lot. Anyway, as far as I can understand it, your friend either was hit by a copper or hit out first — there’s some argument on that point — then when they jumped Merrall got more of a bashing than they meant, I suspect, because he’s concussed and he’s had his face — well, you’ll see. The thing is he was rolling around and carrying on alarming, asking for you, and the only way I could quieten him was to promise you’d come and see him — listen! There he goes again. He’s a bit of a goer, isn’t he?’

  Kate hurried to the office door and stared in amazement at the far cubicle, from behind the curtains of which a great roar of rage was coming. She couldn’t hear any words, but that it was Oliver there could be no doubt; she knew that voice far too well; and she moved swiftly, crossing the floor so fast that she almost slithered, and reached for the curtain to the cubicle as Sister came hurrying behind her.

  ‘Hold on,’ Sister was saying. ‘Let me explain something, Kate —’

  But Kate paid no attention and tried to push through the curtains as Oliver kept up his shouting, and then was stopped as a large and heavy hand landed on her shoulder.

  ‘Sister said you’re not to go in there.’ One of the policemen was looking at her almost reproachfully. ‘Sister said —’

  Mary caught up with her and said, ‘Kate, take care now. He really is very concussed and in a bit of a state. Started hitting out a bit, to tell the truth, when we tried to stop him standing up. He wanted to go and look for you, you see, and of course I couldn’t let him, not till he’d had his skull X-rayed and we couldn’t be sure he wasn’t more damaged than we could see. And —’

 

‹ Prev