Busman's Holiday, page 14
‘That is kind!’ She smiled as if he were David or Charles. ‘I only wish there’s more I could do to help. I’ll expect you both when I see you.’
Fifteen minutes later, Sir Martin at his own request, was getting into a mask and gown to act as a surgical dresser in the Accident Receiving Room. I was in the nurses’ changing-room in the Theatre Department. The first of the fleet of ambulances had already reached Arumchester County Hospital and the faint haze from the river was thickening.
Chapter Seven
‘Now, this one, Nurse.’
The speaker was Mr. Yates, the senior consultant surgeon to the Arumchester Hospitals Group. He watched me slide my gloved hand under his, made sure I was holding the instrument he required before removing his right hand and stretching it out behind him for the theatre sister ‘taking’ the case, to place in his upturned palm what he next wanted. As this was Sister Baird, the Head of the Theatre Department, and they had worked together for years, not once all night had Mr. Yates had to voice a request to her.
He had been sitting down to Sunday supper with his family when the emergency call reached him and started operating at eight-thirty. It was now two-thirty on Monday morning and our present patient was the eleventh operation since we started.
Mr. Hall, the short, fair Orthopaedic Registrar who had treated Aunt Joey, was now assisting Mr. Yates and working on the other side of the operating table. He had only been able to take over from the previous assistant, a house-surgeon, two hours ago, as only then could he leave the Accident Receiving Room.
Sir Martin’s warning to Aunt Joey had unhappily been proved as correct as was to be expected from a surgeon of his vast experience. Though the Arumchester police control room had instantly alerted every road patrol and breakdown service in the area directly news of the crash had reached them, and had as instantly set about sealing-off that stretch of the motorway, a spate of crashes had continued in other stretches.
Mr. Yates, in common with many surgeons, preferred to operate in silence. Being a very temporary incomer, etiquette prevented my asking the many questions that had been haunting me all night. Miss Best had left it to Sister Baird to use me as she saw fit. Sister Baird hadn’t hesitated over her decision. ‘There’s no time for even a lightning tour or quick run-through the techniques we use here, and those vary slightly in all theatres. But the actual operative techniques vary very little and being theatre-trained, you’ll be able to act as “dresser” for the surgeons and replace my male staff nurse who is badly needed in the ARR.’ We had both looked up as the red light over the nurses’ changing-room door began flashing on and off. ‘The ARR are sending us our first patient. Whisk through the shower, get into a sterile tunic, jeans, cap and mask in the towelling area, then go straight on into the theatre, scrub-up and get into a sterile gown and gloves.’
Our anaesthetist for the night was the consultant cardiologist, Dr. Morgan-Jones. He had not been called in, as technically, this was a surgical emergency, but again as Sir Martin had anticipated, within minutes of hearing the news, every consultant in the Group had arrived at the hospital and offered his services wherever needed. By taking over the anaesthetics, Dr. Morgan-Jones had freed the young Resident Anaesthetist to assist in the ARR. ‘And it is there,’ Mr. Yates remarked earlier between cases, ‘the lives will be saved tonight. Once saved, in here we’ll start repairing the damage.’
From the snatches of conversation in the pauses for re-scrubbing hands and arms and changing gowns and gloves, between each operation, I was able to piece together only a very blurred picture of what was happening beyond the smooth, curved, windowless, theatre-proper, walls.
Fairly often, between cases, Dr. Morgan-Jones’s advice was needed elsewhere. Each time he hurried back looking very grave. When Mr. Hall joined us, Dr. Morgan-Jones admitted the ARR tonight had more than once reminded him of the last war after an air-raid. ‘Doubt you were born then, Hall.’
‘Born, sir, but not in kindergarten.’ Mr. Hall rubbed soap to his elbows. ‘Tonight’s my worst, and a police sergeant told me the scene down on the motorway was the worst he’d seen in twenty-five years. A patrol roadman who was on the spot when the visibility suddenly fell to next to nothing, told me it was like a nightmare. Despite there being a mist the whole length of the motorway and warning lights everywhere, the traffic kept on at high speeds, and suddenly, on both sides, vehicles were crashing into each other and flying all around as if drivers and machines had gone crazy.’
‘I don’t know!’ Mr. Yates sighed. ‘I do not know! What goes on in a driver’s mind when he gets behind a wheel on a good road? What makes him ignore the warnings of the elements, the police, and his own common sense?’
No one answered as no one knew how to.
The ‘dirty’ nurse caught my eye and gave me another of her many sympathetic nods. I had had no chance to know her name, but she was a staff nurse of roughly my age and as chubby as Nicky. She had tied the waiststring of her gown loosely, and as she raced lightly and silently round, in her capacity as the one liaison between the operating team and the outside world, she looked like a nippy, comfortable little bolster. In one interval around midnight I heard Sister quietly suggest she went off. ‘You’ve been on all day, Staff. I’ll ask for one of the night staff.’
‘Thanks, Sister, but I’d rather stay. Haven’t you been on all day too? And all the day staff that volunteered to work on?’
Our one frequent visitor was one of the pathologists, a Dr. May. Several of our patients had needed blood transfusions during, as well as before, their operations and Dr. May was in charge of the hospital’s Blood Bank. ‘We’ve already used more tonight than in a normal month,’ he said before midnight.
Dr. Morgan-Jones frowned over his half-lensed glasses. ‘Are you going to have enough, Joe?’
‘Enough for those in the more common groups.’ He dried his hands and eased himself into a sterile gown. ‘Sorry to use up so many of your gowns, Sister.’
‘I’m happy to say we’ve ample stocks of gowns, Doctor. How are your rarer groups holding out? Or aren’t many patients in rare groups tonight?’
‘We’ve five who come under the fairly-rare category, and as luck ‒ if that’s not the wrong word ‒ would have it, all five are amongst the seventeen on the danger list. One’s a small boy of eight who was in that minibus.’
The thought of those nine Arumchester children returning from a seaside outing had been haunting the theatre all night.
Dr. Morgan-Jones looked up. ‘Young Tony Thomas? Dr. Loftus asked me to look at him just now. I did.’ He shook his head. ‘Nothing I could do for him that Dr. Loftus can’t do as well, if not better, as he knows the lad. All sick children are happier with the faces they recognise around their cots ‒ and that’s a very sick child. The internal haemorrhage has now stopped, but they nearly lost him earlier.’
Mr. Hall rinsed his hands, and forearms. ‘When I followed Dr. Loftus into the ambulance to get Tony out, I thought we had lost him before he arrived.’ He hesitated. ‘You will have enough blood for him, Joe?’ Suddenly the atmosphere was electric. I drew on a glove very carefully as we waited for the answer.
‘I’ve four pints left in his group. Dr. Loftus has got two of them for Tony, Intensive Care have got to have the other two. But I’ve rung all round the county, the neighbouring counties and London, and six promised pints should be with us by morning. I have contacted the four donors in that group on our register. The nearest, an Arumchester man, is in bed with a virus infection. Two live at Littlesea, one at Warechester ‒ thirty-three and twenty-eight foggy miles off respectively. All three are coming up, but they’ve not arrived yet and when they will with the blanket outside, is anyone’s guess.’
‘We’ve got the fog here too?’ queried Mr. Hall. ‘I didn’t notice.’
‘You’d no time for that, lad,’ said Dr. Morgan-Jones. ‘I took a look out. There’s a cloud sitting on Arumchester tonight and more than a cloud in more than one home. The parents, the grandparents, the aunties and uncles, the sisters and brothers, the little school-friends and the teachers of these children ‒ there’s sadness in their hearts tonight.’ His deep lilting Welsh voice had a tragic note. ‘In a little place like this, everyone is related to everyone else ‒ and this is their family hospital.’
Sister asked quietly, ‘How are the other children doing?’
‘With care, Sister, with weeks of care, eight of them should live. Little Tony ‒’ Dr. Morgan-Jones paused to shake his head sadly. ‘He’s in no condition yet to stand any operation, but an operation he must have, if he is to live. If Dr. Loftus and Sister Frampton and the many others now attending him so devotedly can restore enough of his strength for Mr. Yates to use his surgical skill, the boy may have a chance. Operate too soon, or too late, and he’ll have none, in my opinion. When that decision can be made, rests with Dr. Loftus. Once made, he will, as we all know, consult with Mr. Yates.’ He hesitated. ‘Two pints in reserve for the child, you said, Joe?’
‘Yes, sir. But ‒ the tide comes in at dawn today. We may get a wind then. We often do.’
‘Often. Dawn remains a long way off.’ Dr. May said, ‘Those were Dr. Loftus’s words before I came in here.’
‘I believe you.’ Dr. Morgan-Jones turned away from the sinks and stared at the empty table. ‘Thirty-four years since I qualified, but I’ve yet to know ‒ nor wish to know ‒ a more distressing experience than having to stand by a cot knowing there is no more I can do and watching a child slip away. All patients touch the heart, but children enter the heart and when they depart, they leave a dreadful emptiness.’ He was briefly silent, then he swung round. ‘There are those I would have standing by that child’s cot tonight. Those drivers, who were in too much of a hurry to get home to their supper, the telly, their dates ‒ to think! I would show them that child now ‒ and his smashed bucket and splintered spade ‒ and I would show them the agony of his young parents and devoted grandparents ‒ and I would say ‒ look!’ His voice trembled. ‘You were in a hurry to save a few minutes ‒ and ‒ this ‒ is ‒ what ‒ you ‒ have ‒ done ‒ to ‒ this ‒ child.’ The theatre was very silent when his words faded away. Then the red light flashed. In the silence, moving like robots, we took our places to wait for the next patient to be wheeled in.
The last two patients on the adult list had relatively minor injuries. Mr. Yates was finishing the second patient when the ‘dirty’ nurse whispered something in Sister’s ear. Sister nodded, waited a few seconds till Mr. Yates stepped back. ‘Right, Hall. You can stitch up.’
‘Mr. Yates, Dr. Loftus would like a word with you on the ’phone. Shall I have his voice put through the loud-speaker?’
‘If this man’s the last we’re expecting, Sister I may as well take it outside. Your duty-room? Right.’
Dr. Morgan-Jones peered under the patient’s anaesthetic mask. ‘He’s had enough and taken it nicely.’ He adjusted the various knobs and switches on the anaesthetic machine. ‘This sounds hopeful Sister. We could be doing young Tony next.’
I had not dared to think of that small boy, or David. My job had needed total concentration and steady hands. It had been a long night and the powerful shadowless overhead lights were hotter than I had ever realised, as never before had I spent so many hours standing directly under them on the same spot.
Now, for a few moments I could think and my heart felt as if squeezed by a harsh hand.
‘I sincerely hope you are right, Doctor,’ said Sister and I hoped that as I had never hoped for anything before.
But the routine went on, smoothly. The theatre porters wheeled in the theatre trolley, the patient was lifted from the table, the operating team removed gowns and gloves, Sister whisked away her instrument trolley, the ‘dirty’ nurse raced round clearing the theatre. Even if we had finished our last case for the night, the theatre would have to be cleared and re-set with the emergency setting left ready when the theatre was empty. Mr. Hall asked, ‘Sister, should we start scrubbing, or wait?’
Sister glanced at the clock. ‘From his delay, I would say Mr. Yates has gone down to look at Tony Thomas. Knowing Mr. Yates’s methods, I should start scrubbing.’
Mr. Hall turned on the elbow taps in the sink next to mine. ‘If the kid can be done, it’s almost certainly a case of now, or never. His reserves’ll be so low that even if up enough for an op now, that could only be a very temporary rally. Still, my chief’s absence is a good sign.’
‘I do hope so, Mr. Hall!’
‘You and me, both, Nurse.’ He glanced at me, suddenly curiously. ‘Thought I knew your eyes, but I don’t know your voice. You from one of our other hospitals in the Group?’
This was no time for explaining I had Aunt Joey’s eyes and she was one of his patients. I shook my head. ‘I’m from Martha’s, London. Sort of on loan.’
His eyes smiled faintly. ‘Very glad we are for the loan. Martha’s? Same as Matron and Sue Frampton ‒ Sister Children. Know her?’
‘Of her. She trained before I started.’
‘Guess she would. Good thing she’s back from her holiday. She’s so good with sick children. This is going to hit her as hard as Dr. Loftus. Those two take their sick kids to heart ‒ which is why they’re so good with them. Two pints. H’m.’
‘Not enough?’
‘Depends on so many things. Could be. Must admit if I were Loftus, I’d feel much happier to have at least one more.’
As he was the first person to have time to talk to me since the night started, and as he was registrar which meant that etiquette allowed me to question him, I asked which blood group this was?
‘Not all that rare, except in Arumchester tonight.’ He named it.
The soap dropped out of my hands. ‘Mine.’
He stared at me. ‘Sure?’
‘Positive.’
The new hope suddenly vanished from his eyes. ‘We’re not allowed to use members of the staff as donors, here. Hospital rule.’
‘But I’m not a member of the staff. I just happen to be staying in Arumchester as a private citizen.’
He turned off his taps. ‘Hang on. I’ll take this to the top brass.’ He walked over and talked quietly to Dr. Morgan-Jones, who as I later discovered was senior consultant to the Group. Dr. Morgan-Jones talked quietly to Sister. Sister beckoned me. ‘You’re willing, Nurse?’
‘Very, Sister.’
She glanced at the consultant. ‘Matron should be consulted.’
‘I’ll talk to Matron, Sister. Hall, get Dr. May here, stat. He’ll have to test first to be sure Nurse matches. By that time I should have Matron’s permission.’
Sister told me to go and wait in her duty-room. ‘If all is well, rest there after for as long as Dr. May considers necessary, then get changed and we’ll arrange some means of transporting you home.’
‘Sister, thank you, but after a little break, can’t I come back and help in here?’
She stiffened, but her eyes smiled. ‘You try and return to my theatre after donating blood at your peril, Staff Nurse! If I’m not free to see you before you leave us, very many thanks for all you’ve done ‒ and there’s Dr. May outside.’ She nodded at his white-coated figure hovering by one of the glass portholes in the double doors. ‘Off you go, and thank you, again!’
It only took seconds for Dr. May to take the tiny sample of blood he needed for his test and ask the required medical questions about my health. ‘Splendid! Let’s hope this is all right! I haven’t told the pundits yet for fear of raising false hopes.’ He vanished so fast his coat floated out behind him. He was back nearly as fast. ‘Perfect match! I’ve told Dr. Loftus I’ll have another pint for him in twenty minutes. Young Tony’s about to come up in his cot.’
I was half-sitting, half-lying under a theatre rug on the rather hard horsehair couch in the duty-room when I heard the cot rumble softly by the closed door about ten minutes later. I just caught David’s quiet voice telling the ‘dirty’ nurse Sister Frampton would be staying in the theatre throughout the operation and that he would be watching for a little while, but was expecting a telephone call from some other sick child’s parents. ‘Let me know at once, please, Nurse. They’re on holiday and the police have had difficulty in tracing them, but have just told me they’ve broken the news.’
I had not seen Sue Frampton since that last evening up north. I had not realised her holiday was over and she was back in Arumchester. How odd, I thought, not to know. Then I thought, how could I know? I had slipped automatically back into the theatre world tonight, because theatres were little worlds of their own. Not David’s world. He had his own world here, I did not belong in it, so why be surprised no one had told me his great friend and colleague was back?
‘Having a nice little snooze? Splendid!’ The pathologist was back. ‘How are we doing?’ He bent over the tray he had arranged on a low table beside my temporarily splinted left arm. ‘Nearly up to the mark. Nurse, were it not for etiquette and my deep devotion to my very pretty wife, I could hug you for the weight you’ve taken off my mind. I’ve just had a call from the police. My Warechester donor has had a puncture ten miles off, and as his spare tyre’s flat, they’re bringing him in and dealing with his car, later. Have those men worked tonight!’
‘Doctor, I’m so glad. How about Littlesea donors?’
‘No word from either since they left home. But this ‒’ he began disconnecting the apparatus, ‘is corn in Egypt at the exact moment it’s wanted. We haven’t needed it earlier, mayn’t need it later. It’s now ‒ and we now have it!’ He sealed the special bottle and produced a stick-on label from his breast pocket. ‘Now all the details that are an Arumchester Hospitals’ rule. Not all that searching. Just name, age, occupation, married or single ‒ and don’t ask me why. I didn’t make the rules. I just keep ’em!’
He was such a pleasant, friendly man, of about David’s age and so exactly like so many medics I had worked with that I answered as if we had been working together for ages and not merely one night.
