by A. J. Cronin
“Right!” he said. “I’ll have Reid in at once.”
Without delay he called Reid, and while Cameron set out alone on the afternoon round the two younger doctors went into consultation at the Pulaski’s house.
Reid, deeply gratified by Finlay’s invitation, professed full knowledge of Mitchell’s recent work, and he made it plain in no uncertain fashion that this new condition known as appendicitis was to him an open book.
“I went through the reports of the John Hopkins Hospital only last month,” he added. “You’ve seen them I suppose?”
“No,” replied Finlay dourly “But I’ve seen this case.”
Reid said no more for the moment but went on with his thorough examination of the boy. When he had finished he followed Finlay into the other room, lit a cigarette, and, planting his legs apart, blew a long cloud of smoke towards the ceiling. He seemed absorbed in thought, but at last, with a certain diffidence, he spoke
“Frankly, Finlay,” said he, “ I can’t agree with your diagnosis. As I’ve told you, I’m up to this thing. Absolutely man. But this isn’t it. I don’t look on this as any more than a simple inflammation. The boy’s vomiting has stopped, his temperature has fallen, his mother says he is complaining of less pain”
Reid waved his cigarette. “I’m sorry, Finlay, to disagree with you, but I’m confident you’re wrong. There’s no appendicitis here. I couldn’t, under the circumstances, become a party to advising operative treatment. Wait and see, my boy, that’s the idea here – a masterly inactivity.”
And with a friendly little nod, Reid took himself away.
But Finlay did not leave the house. Somehow he could not. Far from reassured by Reid’s words, he wandered back into the little bedroom where Paul lay, and stared at the passive figure of the boy.
It was perfectly true, as Reid had said, the vomitting had ceased and the pain was less, but this, in Finlay’s eyes, marked not an improvement but a rapid deterioration in the patient’s condition.
He took Paul’s hand
“Does it still hurt you?” he asked.
“It doesn’t hurt me so much. But I feel awful queer. It’s kind of black in the room.”
Finlay bit his lip. The pulse, racing under his fingers, coupled with a falling temperature, bore down upon him ominously.
Here, in this poor and squalid home, he felt himself faced with that awful figure – the dark angel of death. He must do something – he must. Cameron could not help him, Reid had failed him; the decision rested entirely with him.
For a full five minutes Finlay stood motionless, staring down at the narrow disordered bed. Then across his set face a light spread suddenly.
He had it! Why hadn’t he thought of it before? He would ring up a certain professor in Glasgow. The professor knew him, remembered him as his house surgeon, would undoubtedly with his unfailing charity, run down and see this humble case. The professor on occasion could demand a hundred guinea fee and a special train to transport him to his lordly patients; but on other occasions he would come obscurely, and for nothing, in the cause of mercy. This was such an occasion, and Finlay was sure of his man.
Turning, he went into the other room, where Mrs. Pulaski stood with a clutter of frightened youngsters clutching at her skirts, and in as few words as possible he explained that Paul would have to go to hospital immediately.
“Hospital!” echoed the frightened woman. “Holy mother! Is he that sick, doctor?”
“Yes,” said Finlay, “and he’ll be worse unless we do something quickly.”
Sitting down at the table, he took his prescription pad and dashed off a hurried note to Matron Clark at the hospital instructing her to send the ambulance for Paul and prepare for the operation by the professor that evening.
Then, comforting the weeping mother as best he could, he hurried back to Arden House, where, without delay, he put through a call to Glasgow, and was connected to the professor’s house.
But here he received a rude shock. The professor had left two days before to spend a fortnight’s vacation in the South of England.
Completely dismayed, Finlay replaced the receiver, and rested his head in both hands. He knew no other surgeon well enough to ask him to undertake the journey to Levenford and to perform the operation without fee. Caught in a dilemma of his own making, he felt trapped and helpless.
But time was not standing still, and he could not afford to waste one precious moment. Though he did not know what he was going to do, he was still conscious that he must act – act immediately.
Rousing himself, he went out of the house and walked rapidly across the Common towards the Cottage Hospital. He entered the hospital, and went straight to the matron’s room, but she was not there, and so he turned and made his way into the ward.
Nurse Angus was in the ward, standing beside the clean white bed in which Paul now lay, and as Finlay entered she looked up and met his eyes, not in her usual impersonal manner, but with a strange intentness.
“He’s very bad,” she said in a low voice. “Temperature subnormal, and the pulse almost imperceptible. He seems to be slipping into coma.”
With his gaze upon the bed Finlay saw that she was right. He muttered –
“It’s a bad lookout, I’m afraid,” he paused, then blurted out – “The Professor can’t come. I can’t get anyone to tackle it. We’ll have to do the best we can without an operation.”
He did not look at her, but waited instinctively for some cold reply. He knew that now she must despise him more than ever. His heart sank. But to his amazement she did not speak. He lifted his head and found her warm eyes fixed steadily upon him.
“Do you mean that there’s no one to do this operation? And you know that it must be done!”
He nodded his head dumbly, conscious of her presence, of her disturbing scrutiny. There was a long pause, then she said slowly and distinctively –
“Why don’t you do it yourself?”
He stared at her, staggered at the suggestion, yet strangely thrilled by it. And, all at once, inspiration flowed to him from the composure in her face. He had never dreamed of tackling the operation himself, for although he knew its technique from reading, he had felt it far beyond him.
He had operated, of course, in a small way, but a major abdominal operation had stood always as difficult, dangerous, and obscure, something quite outside his power. But now, with this sudden suggestion offered so unexpectedly, his purpose deepened. He realised that it was the only thing to do, that he must make
the attempt.
At that moment the matron came waddling up.
“The theatre’s ready,” she announced officiously. “Whenever the
professor arrives we are ready to begin.”
Finlay faced her with real determination.
“He’s not coming,” he declared. “But for all that, we’ll begin at once. I’m going to do the operation myself.”
“You!” gasped the matron.
“Exactly,” said Finlay abruptly.
“But, Dr. Finlay –” protested the matron.
Finlay did not wait. Before the astounded woman could say more he walked out of the ward and into the little office, where, picking up the telephone again, he rang through to Reid’s house.
It would have been easier by far for him to have asked Cameron to give the anaesthetic, but now he did not want the easy way. He wanted Reid to be there, since he had disagreed with his diagnosis, to see everything, to witness the best or the worst that he could do.
Three-quarters of an hour later Finlay stood in the operating theatre ready to begin. The theatre was hot. The sun had been shining through the ground glass windows, and it was full of a hot bubbling and hissing from the small steam steriliser.
Exactly in the centre of the theatre was the operating table, breathing unevenly under the anaesthetic was Paul.
At the head of the table, very disturbed and unwilling, sat Dr. Reid. He had made it perfectly clear that he came merely to giv
e the anaesthetic and would take no responsibility for the issue.
Beside her tray of instruments was Nurse Angus – still calm, and impenetrable in her demeanour – while beside the metal cylinder of oxygen, as though she felt that she would soon be obliged to use it, was Matron Clark.
It was the moment at last. With a quick prayer, Finlay bent over the table and reached out his hand for a lancet.
He concentrated on the one neat square of Paul’s body surrounded by white towels and coloured a fine bright yellow with iodine. It was inside the square that everything would take place.
He tried, in the hot room through the daze of his conflicting emotions, to remember everything that he must do.
Aware above everything of the presence of Nurse Angus he drew a deep breath.
First there came the incision. Yes, the incision came first. The warm, shining lancet drew a slow, firm line across the bright yellow skin, and the skin parted in a red gash.
Little voices whispered inside Finlay’s brain, mocking him, telling him he would never be able to accomplish the impossible task he had undertaken.
On and on he went. He used more instruments, and the rings of forceps lay deeply one upon another.
The confusion of the instruments seemed inextricable, and, all at once, through the steaming heat of the theatre, the broken breathing of the patient, the latent uneasiness in Reid’s eyes, there came upon Finlay the sudden paralysing thought that he could not continue.
He was a fool, a hopeless, incompetent fool, muddling about in the darkness looking for this thing they called the appendix, which did not, could not exist. Beads of sweat started upon his brow. He thought for a moment he was going to faint.
And then, through the anguish of this horrible uncertainty, he felt the eyes of Nurse Angus upon him. There was something open and revealing in those eyes; suffering because he suffered, enduring every pang which he endured, yet strangely courageous and pleasing. But there was something more which glistened there, and entered into Finlay’s soul with a stab of ecstasy.
In a flash the mist passed, he took command of himself, and, bending, went on courageously with the operation.
All this happened quicker than can be told. It was the turning-point, the crisis of the operation. A second later Finlay’s searching hand discovered the appendix and withdrew it to open view.
A kind of gasp broke from Matron Clark’s lips, and Reid’s face expressed unwilling admiration, for there, exposed for them all to see, was a round swelling, an abscess in the appendix, almost gangrenous.
Filled with a rising exultation, Finlay hurried his movements. He was vindicated, completely vindicated. Out came the appendix, and in went the sutures.
Quickly the operation drew to a close. Confident now, Finlay put in the stitches with a beautiful precision. It was nearly over now, sealed up beautifully and finished.
The matron coughed diffidently, and ended the long silence. Nurse Angus had begun to count the swabs. At last it was over, and the door swung open, and the wheel-stretcher went out, bearing Paul to the ward.
Finlay watched the swing-doors close upon the wheel-stretcher as Matron Clark ushered it officiously into the ward. He knew that Paul would recover now.
He turned and saw Reid coming towards him. He no longer looked cold and remote and uneasy. He said with real cordiality –
“I want you to know, Finlay, that you were right and I was wrong. Man, I admire you for what you’ve done.”
He held out his hand, and Finlay took it. He was grateful to Reid, but when the other doctor left the theatre the strain of what he had gone through struck him again, and he sat down quite weakly on a stool.
Then he was conscious that Nurse Angus was still in the theatre. She stood looking at him, then went to the tap, ran the water hard, filled the tumbler, then gave it to him. Finlay drank it, then gazed at her with a surging gratitude.
“I want to thank you,” he muttered, “for helping me, advising me. Oh, I’d never have done it but for you.”
Then he broke off.
There was a silence. Her face was turned from him now, but tears were in her eyes. At length she said –
“I knew you could do it. And you did. It was splendid.”
Her voice, low yet thrilling, set his heart thudding.
He sensed the pulse of some secret feeling in her which suddenly
intoxicated him. A light of understanding broke over him. Had he
been wrong in thinking she disliked him?
Her name rose instinctively to his lips. But before he could speak
she turned quickly and was gone.
13. The Fête at Dunhill
Finlay was in love – deeply and hopelessly. He knew that without Peggy Angus beside him to share his life he would not be happy.
And yet he could not put his fortune to the crucial test. For, on the day following his dramatic operation on the little boy, Paul, the most unexpected and banal occurrence took place. Peggy’s summer holiday fell due, and she left quite quietly and unostentatiously to spend the fortnight with her folks at Dunhill.
When she had gone Finlay had full opportunity to examine his own position. He had begun by distrusting Peggy because of her family, good position, and obvious command of wealth. He had been suspicious, feeling that it was wrong for her to be a nurse, and that she was posing, insincere. And, behaving contrary to his own generous nature, he had at the outset created a painful misunderstanding between them, a gulf which later on he had despairingly felt he would never bridge.
But now a ray of comfort shone for him.
Peggy’s interest in his work, as shown so sincerely and spontaneously at the recent operation, gave him fresh hope. Perhaps, after all, she did care for him a little. His heart bounded at the very thought, and he longed for the chance to ask her that question humbly and openly. The chance came, too, sooner than he anticipated.
A few days after Peggy had gone on holiday, Matron Clark greeted Finlay at the hospital in great good spirits.
“They’re having a fête at Dunhill next Saturday,” she declared. “Mr. Angus has lent his grounds. A lovely place they have up there.
And the funds are to go to the hospital. Isn’t it splendid? Nurse Angus has arranged the whole thing.”
At the very mention of Peggy’s name and the thought that he might see her at the fete, Finlay’s pulse quickened.
“That’s fine,” he said to the matron, trying to keep his tone unconcerned. “ You’ll be going up?”
“I am indeed,” agreed the matron with a brisk nod. “And I’m counting on you to drive me up, doctor.”
Finlay shook his head diffidently.
“They’ll not want me up there,” he answered, hoping to be contradicted. “I’m not exactly a favourite in that quarter.”
“Nonsense!” replied the matron. “And besides, it’s your duty to be there, seeing it’s a charity for the hospital.”
A slow smile came to Finlay’s face.
“Oh, well,” said he, “if that’s the case, I’ll not deny I’d like to go.”
From that moment Finlay began to look forward to the proposed function with his whole heart.
On the following afternoon when he got home he found a letter from old John Angus cordially inviting him to the fête. Finlay studied it in silence. Had Peggy mentioned him to her father? Perhaps she had spoken for him kindly.
Overcome by a feeling of mingled ecstacy and suspense, Finlay sat down and quickly wrote his acceptance.
It was he told himself, an almost providential opportunity, and as the day of the fete drew near his beating sense of anticipation increased. On that day he would ask Peggy to be his wife.
Saturday came, bright and clear, and Finlay himself made arrangements to drive matron up to Dunhill. But at eleven o’clock on that forenoon an accident happened at the shipyard. Bob Paxton, son of old John Paxton, the foundry foreman, fell from the upper deck of the Argentine cattle boat then in No. 5 Graving Dock, and was
brought to the Cottage Hospital suffering from serious internal injuries and concealed haemorrhage.
Finlay, long since a friend of the Paxton family, was called to Bob, and his view of the lad’s condition was grave. So grave, in fact, that he hesitated about leaving the case for long, and with a dubious frown, he indicated to matron the inadvisability of his going to Dunhill.
“It’s the haemorrhage I’m afraid of,” he added. “ I think we might have to do a transfusion.”
Matron raised her hands instantly.
“That’s not a thing to rush into, doctor. And, besides, you wouldn’t think of doing it till this evening, anyhow.”
She was all ready for the expedition, and provoked to think of any interference with her pleasure.
Finlay’s look grew still more doubtful. He, too, wanted to go to Dunhill with all his soul, but the strong sense of duty in him revolted at the idea of putting himself out of touch with this critical case.
He refused to commit himself until he had seen his patient again, and at two o’clock he returned to the hospital and again made his examination of the lad.
This time he had to agree that the symptoms were more encouraging. Bob had recovered consciousness, and, though very pallid from the effect of the internal bleeding, stoutly protested that he was “fine”.
Added to matron’s pleadings, this persuaded Finlay. He instructed Nurse Cotter, who remained on duty, to keep a constant eye on the case. He himself would be back without fail at six o’clock sharp.
So matron and Finlay set out together just after two. Thanks to the splendour of the day and the enjoyment of the drive, the grim reality of the hospital ward which they had left behind them soon faded.