Going Under

by Sonia Henry

  Her eyes are so puffy they’re like slits. Her beautiful thick hair is dishevelled and she is wearing a ripped scrub top. It looks as if she left the house after dressing herself in the dark.

  ‘It’s happened, mate,’ she says. ‘The worst has happened.’

  I wait.

  ‘I’ve killed someone.’

  I stare at her. I don’t understand what she means.

  ‘All interns kill people,’ I say. ‘It happens all the time. It’s just part of being a doctor. It’s not our fault.’ Estelle knows this as well as I do, and inside I know that we’re not meeting in a utility room late at night because a ninety-nine-year-old with pneumonia has died on Estelle’s night shift.

  I sit down next to her, moving a mop and a bag of adult nappies out of the way.

  ‘Do you remember that little boy I had to intubate when we were out in the middle of fucking nowhere?’ she asks, her voice hoarse.

  ‘I thought that turned out okay!’ I say, feeling the panic rise.

  Estelle shakes her head. ‘Apparently it went to the coroner.’

  I hadn’t realised the patient died.

  ‘But that doesn’t mean you killed him,’ I protest loudly. ‘Every unexpected medical death goes to the coroner.’

  We hear a clanging sound from the wall behind us, where some hapless registrar is undoubtedly getting ready to go into theatre.

  ‘Shhh!’ Estelle hisses.

  ‘Sorry,’ I whisper. ‘But why has this come up now?’

  Estelle puts her head in her hands. ‘They’re doing an inquest. I’ve been called to give evidence.’

  ‘Fuck!’ I exclaim.

  The clanging next door stops.

  ‘Shhhhh!’

  I put my hand over my mouth.

  ‘I got home pretty late,’ she explains in a whisper, ‘and there was a letter in the mailbox.’

  I cringe. I can barely handle an electricity bill, let alone a career-ruining summons to appear in court.

  ‘I freaked out. I decided to wait until I knew less people would be around, then I came back here to see if I could access the Wingabby system from our computers. You know, to see what I’d documented at the time. But I couldn’t access it.’ Her fingers are tapping the ground nervously. ‘I tried to call you, but you weren’t answering. So I texted you and then came and hid in here.’

  I’m still trying to take it all in. ‘So what did the letter say?’ I ask finally. ‘Do you have to go to court? Can’t you just—I don’t know—submit a written statement?’

  ‘No,’ she says, sounding tired. ‘I don’t think they’re looking to blame me, necessarily, but I have to go to court. Everyone will know what happened … It’ll be in the paper for sure. You know how the media loves slamming doctors. It’ll probably wreck my job prospects—no one wants to hire someone who’s been linked to such a major fuck-up this early on in their career.’

  ‘What was the cause of death?’ I say, almost too afraid to ask.

  She looks totally defeated. ‘They’re not one hundred per cent sure yet—they still need to wait a few weeks for the forensic analysis. But apparently when they opened him up the ETT tube was in his oesophagus, going into his stomach.’

  I swallow.

  ‘I intubated a child’s fucking oesophagus,’ Estelle whispers, wiping away tears. ‘I stuck a tube that was meant to go into an airway into the food pipe instead. It’s no good, mate. I definitely killed him. He wouldn’t have been getting any oxygen. I shoved the tube down the wrong hole, and now he’s dead.’

  I can’t think of a single thing to say.

  ‘I killed him,’ she repeats.

  ‘But it was just a mistake!’ I whisper furiously. ‘You had no support, you were stuck there alone, you did the best you could! Mistakes like that happen all the fucking time!’

  ‘Yeah, and kids don’t always die,’ Estelle replies flatly.

  We sit there in the dark in complete silence.

  I feel sick.

  ‘Inquests are standard practice,’ I say finally, trying to reassure her. ‘They have to do them—heaps of surgeons have shit go wrong and go to inquests and then everyone forgets about it. Remember that cardiac surgeon ages ago? When that kid died? I’ll show you the articles.’

  ‘It’s different when you’re a boss,’ she points out. ‘They’re protected because they make the private hospital so much money. No one gives two shits about putting us in situations they know we can’t handle then throwing us under the bus.’

  ‘That’s not true!’ I protest, knowing even as I say it that she’s right.

  We’ve lapsed into silence again when another clang comes from behind the wall, a little louder than the previous sounds. It seems to be uncomfortably close to where we’re sitting, and Estelle and I shift uneasily. The last thing we need is for anyone to overhear us discussing this train wreck.

  ‘I shouldn’t be telling you this here,’ Estelle whispers. ‘I don’t even know why I suggested we meet in this cupboard. I just felt so overwhelmed and I couldn’t breathe and it was the only place I could think of to hide.’

  ‘Well, I know number nineteen is a bit shabby, but maybe next time you should just come over,’ I tease gently.

  Estelle half smiles. ‘I better go,’ she says, the horror of her situation crossing her face like a fleeting shadow.

  We both stand up. I push the door open and we step into the corridor. As we walk quietly towards the stairs, I feel suddenly like we are ghosts. Shadows of ideas and happiness, echoes in time, floating through an old dimly lit hospital corridor with all the other memories of people suffering.

  It isn’t until we get to the front of the hospital that I realise with dismay that I have left my keys in the utility cupboard.

  ‘You go,’ I tell Estelle, annoyed with myself. ‘I’ll see you tomorrow.’

  I return to the operating theatres, jog back down the hallway to the cupboard and push the door open. Using my phone light, I manage to locate my keys almost immediately. Relieved, I pick them up and turn to leave when I’m startled by the sound of a high-pitched giggle floating through the wall.

  I stop.

  It sounds like a woman, I think, confused. But I’m sure the cupboard adjoins the men’s change room.

  Could it be the cleaner?

  I hear a shuffling sound, then the giggle again. It’s definitely female. And it sounds almost familiar.

  I know I should leave, but curiosity gets the better of me. It sounds like one of the surgeons is getting a little bit of extra action with a theatre nurse.

  I hear a moan, and then a man’s voice says, ‘That’s it, you little slut. That’s it, take that dick.’

  Jesus. This is getting heavy. Okay, I understand that people might get into that kind of role play in the privacy of their own homes, but to do it in the operating theatre change room is too much. And I find the word ‘slut’ offensive.

  ‘Suck it, bitch.’

  All of a sudden I want to vomit. I know who the voice belongs to. He’s only been making my life hell for the last eight months. It’s the Joker.

  I stand there, paralysed. In my moment of indecision, which feels like an eternity, I hear the Joker panting and groaning his way through what sounds like the world’s most disgusting blow job. When it finally ends, I have my fingers in my ears. I can’t imagine what poor nurse would think it’s a good idea to go down on a man as revolting as that.

  There’s some murmuring, and then the squeal of hinges as a door is opened. Thank God, they’re leaving.

  I give them a few minutes’ head start then push open the door of the closet. I need to go home. I need to get out of this parallel universe of mops and dead babies and inquests and blow jobs and go the fuck back to bed.

  As I step into the corridor, the door of the men’s change room swings open.

  ‘Katarina! What the fuck are you doing here? Aren’t you meant to be sick?’

  I gape at her. I can’t believe it. It’s the Smiling Assassin.r />
  thirty-four

  We both stand very still.

  I stare in horror at the Smiling Assassin, who isn’t smiling now. Her eyes have such a frightening glint in them, I fear for a moment that she’s going to hit me.

  ‘Ah …’ At first I can’t speak. For the second time this evening, I’m rendered speechless. Then the words rush out in a flood, unfiltered. ‘You gave him a blow job? But he’s disgusting! He treats everyone like shit—he is a shit! I mean, seriously? A blow job in the men’s change rooms? What the actual fuck? Are you—’

  ‘You think I enjoy it?’ she hisses, cutting me off. ‘You actually think I enjoy doing that?’ Her eyes burn like coals. ‘It’s all right for you,’ she spits at me. ‘You don’t even care. You’ll never make it as a surgeon. You don’t have what it takes. You have to want it more than anything, and you have to give it everything. Don’t you get it? DON’T YOU FUCKING GET IT?!’

  No, I think, staring at her. I definitely don’t get it.

  ‘But you’ve just sucked off the most horrible man I’ve ever met!’ I say incredulously. ‘Are you out of your fucking mind?’

  ‘I want to keep my job!’ she nearly screams at me. ‘Do you know how hard it is for a woman to get a surgical position at this hospital? I don’t have any choice! I have worked so hard to become a surgeon. I have sacrificed years of my life. And if I have to give one creep a few blow jobs to keep this job, then I’ll fucking do it. Don’t you understand, you naive little girl? Don’t you know what he’ll do to me if I say no? This is how the hospital works! OPEN YOUR FUCKING EYES!’

  Her words echo around the deserted hallway. I just stand there, dumbstruck. Every word is like a sharp slap in the face.

  She’s out of breath, and I can see her eyes glistening with tears. Sadness, or anger—probably both.

  ‘If you tell anyone about this, I’ll ruin you,’ she says.

  Then she turns and walks quickly away.

  PART III

  death

  ‘Sex is also the revenge on death. Don’t forget death. Don’t ever forget it.’

  Philip Roth, The Dying Animal

  thirty-five

  When I was a child I was a bit of a worrier. Mum liked to say I was the only five-year-old with a frown line because I worried so much. My parents thought about taking me to a child psychologist but, in the end, Dad started to meditate with me before I went to sleep.

  Every night Dad and I went and stood under the worry tree, which was in fact of the lemon variety. Together we hung my worries out one by one on the branches and watched them flutter in the breeze. I was able to go to sleep, knowing that my worries were somewhere else, and that the next day I could take any new worries I thought of to the tree.

  Now, as I sit on my bed after walking home from the disaster inside the utility room and outside the change rooms, I think to myself that the lemon tree from my childhood isn’t nearly big enough. I need an enormous oak.

  I don’t sleep a wink. Estelle texts me first thing in the morning to let me know that she’s taking three days off. She asks if I can write her a script for valium. I text her back asking if she’s okay, but she doesn’t reply. I mentally remind myself to nick a script from the ward.

  I get dressed for work with an ever-increasing sense of dread and leave the house deliberately early, avoiding Max and Winnie.

  I reach the surgical ward to find the Smiling Assassin is already there, also unusually early.

  I nod in her direction. ‘Hey.’ I can’t look her in the eye.

  ‘Hey.’ Her tone is clipped. We round in complete silence, apart from her occasional instruction.

  When we reach the fourth patient, I comment that his blood pressure has been a little on the low side. She nods.

  ‘I have to go to theatre,’ she says suddenly, looking me in the eye for the first time. ‘You can finish the round without me.’

  ‘Ah …’ I think of some of the really sick patients that we haven’t seen yet, like Mr Trajevski in bed 9, who has had a huge tumour removed and has only just come out of intensive care.

  Then I remember what her face looked like after our unexpected encounter last night and nod. ‘No worries,’ I say. ‘I’ll let you know if there are any issues.’

  By the time I’ve seen the rest of my list, I pity the Smiling Assassin so much it makes me feel incredibly depressed. It was a lot easier to hate her, I realise as I order a CT scan for Mr Trajevski. I like giving blow jobs to men I’m wildly attracted to, but I firmly believe the act should be enjoyable for both parties. To fellate someone as revolting as the Joker surely isn’t worth it, not even for a good reference. Especially not for a good reference, I correct myself.

  I walk down to the cafeteria for a break, feeling incredibly tired. I can’t wait until the year ends. Maybe I can request a transfer to a new hospital, or something.

  ‘Hey!’ I look up from my coffee to see Max walking towards me.

  ‘Hey.’

  I don’t know whether to tell Max what happened last night with Estelle and then the Smiling Assassin. I have a feeling these are things that shouldn’t be shared lightly. Luckily, Max is starting nights, which means we won’t see much of each other. Usually when he works weird hours he spends half the time at his mum’s place; his room there is darker, which makes it easier to sleep in during daylight hours.

  ‘You left early this morning,’ he says, plonking down next to me. ‘That desperate to get to work after your sick day, huh?’

  ‘Something like that,’ I agree.

  ‘I didn’t get home until pretty late last night.’ Max takes the lid off his coffee and scoops up the foam with his finger. ‘I was helping Dr Glass in theatre. I reckon he’ll give me a good reference.’

  ‘That’s good.’ I try to sound enthusiastic.

  Max doesn’t seem to notice. In fact, he seems distracted himself. Probably the stress of surgical applications.

  ‘Estelle wants to meet up with me and the Godfather after work,’ he says after a pause. ‘Said she has something to tell us. You know she’s taken a few days off work?’

  I’m momentarily relieved. A problem shared is a problem halved, or quartered.

  ‘Estelle’s in the shit,’ I tell him. ‘I’d better let her tell you in person.’

  Max looks at me but doesn’t push. ‘Is that why you’re a bit flat?’

  ‘Yeah, I guess.’ I don’t elaborate. ‘You don’t seem that thrilled to be here either,’ I point out.

  ‘I really don’t want to start nights,’ he says with a frown. ‘I wish I was still on respiratory.’

  Max’s night shifts cover the medical ward, which is probably the worst job in the entire hospital—aside from mine, I realise.

  ‘At least I’m going to Europe in a month or so,’ he says, forcing a smile. ‘Thank God we get annual leave. I mean, they wouldn’t give it to us if they didn’t have to, but at least that’s something.’

  I wish I was going to Europe with Max, I think with a sigh.

  We sit in silence, staring into our coffees. My pager goes off. It’s the Joker. Come to theatre.

  I leave Max to his misery and walk towards the operating theatre.

  The oak tree, overwhelmed with leaves of worry, has transformed into a forest.

  thirty-six

  I count down the minutes to the end, second by second. The remaining days on neurosurgery are nothing short of torture. I’m dreading starting my term in emergency after Estelle’s less-than-positive descriptions of her time in there (‘Totally fucked up’), but anything has to be better than this.

  The atmosphere in operating theatre six is so tense it feels like the scalpels can cut air as well as skin. The Joker, having no idea of my recent insights into his relationship with his registrar, is his usual intolerable self.

  The Smiling Assassin and I have gone from active dislike to active avoidance. She starts showing up late to the ward rounds and finishes early, by default leaving me in charge of all the post-operativ
e patients, which isn’t ideal. The Shark notices I am a single-doctor show and corners me after the trauma meeting on my last day of neurosurgery.

  ‘Doesn’t your registrar round with you anymore?’ he asks as I press the button to take the lift. ‘The nurses tell me you’re running the neurosurgical ward these days.’

  ‘It’s fine.’ I try to smile reassuringly. ‘She’s usually there. It’s just because they’re so busy in theatre now with all the traumas coming in, you know … I can always call her.’

  ‘Mmm.’ He doesn’t sound convinced.

  ‘I’m liking the responsibility,’ I lie, wondering why I’m protecting the Smiling Assassin and briefly considering what will happen if I tell him the truth.

  ‘You’re doing well,’ he says, to my surprise. ‘You should think about doing surgery.’

  Despite the fact I have spent the last God-knows-how-many years imagining myself as a surgeon, for some reason the remark seems totally ridiculous, and I can’t help laughing.

  The Shark looks offended. ‘It wasn’t meant as a joke,’ he says tersely.

  I pull myself together. ‘I don’t know if it’s for me anymore,’ I say honestly as I get into the lift, ‘but thanks.’

  I walk onto the ward for my solo round, still grinning. It isn’t that funny, but the irony amuses me. What is it the French say? L’humour est la politesse du désespoir. Humour is the politeness of despair. Regardless, I enjoy the politeness; laughter has been somewhat lacking in recent times.

  ‘Dr Prince is back from New York,’ a nurse informs me. ‘He wants to do a round.’

  Despite everything that has transpired, I feel butterflies flapping around in my stomach as I walk into the nurses’ station. He’s staring at the patient board. I clear my throat.

  He turns around, and the butterflies start whirring their wings more frantically. I can’t believe, after everything I now know about surgery and surgeons, that he still has this ridiculous effect on me.

  His eyes are grey today, I notice, as he pulls off his scrub cap absentmindedly. ‘I’m sure I have another patient I’ve forgotten,’ he tells me. ‘I must still be on New York time.’