Doctor in Love (2 page)

The following morning I woke in my bare room in the St Swithin’s resident staff quarters feeling like Sisera, who I remembered learning in Divinity had a tent-peg driven through his temple while he slept. The old diagnosis would have been
hangover vulgaris
; but now that my former classmates were scattering both geographically and professionally I rarely had anyone to go drinking with, and I had gone to bed at eleven after a cup of coffee with the night nurse down in casualty.

In the gloomy residents’ dining-room, sitting beneath the chiding eyes of Hippocrates, Lord Lister, and Sir William Osler, I found that I couldn’t eat my breakfast This was unusual, because after even our most shameful student debauches I was always ready for my porridge and kippers as usual the next morning. I managed to swallow a cup of tea, then put on my white coat and crossed the hospital courtyard to my laboratory.

At the time I was coming to the end of my appointment as the junior resident pathologist I spent my days in the pathology block, sitting at a bench richly engrained with the brilliant blues, greens, and reds used for staining bacteria, doing calculations and tests on “specimens”. These were of various sorts, and either sent across daily from the wards by the trayful or borne to us proudly by out-patients in a selection of jam-jars and beer bottles produced from inside the jacket or shopping basket.

“Do you mind if we have the window closed?” I asked the junior pathology demonstrator, my overseer. I pulled a high wooden laboratory stool to my usual place. “It’s a bit nippy this morning.”

“Nippy? It’s a lovely hot summer’s day!”

I drew my microscope towards me and shivered.

“Be a good lad and get on with this pile of blood counts,” he continued. “There’s been a rush of them over from the wards. Then there’s some urines over there I’d like you to tackle when you’re free. They’re beginning to niff a bit.”

When the demonstrator went off to lecture I shut all the windows. Then I was surprised to find that the weather had suddenly turned warmer and I was sweating. The climate was particularly irritating, because that morning my work was twice as troublesome as usual. I had difficulty in focusing the microscope, I kept shaking drops of blood from the little glass sides, and I couldn’t add up. By lunch time I slunk back to my room and laid down, wondering why I felt so tired.

It didn’t occur to me that I was ill. It never does to doctors, who are as shocked to find themselves sick as a policeman to discover that his home has been burgled or a fireman to see his own roof on fire. It was almost through curiosity that I rummaged for a clinical thermometer I kept somewhere in my sock drawer, and slipped it under my tongue.

“Good God!” I said. I had a temperature of a hundred and three.

I sat down on the edge of my bed, faced with the unnerving problem of self-diagnosis.

I gingerly felt my pulse. Ninety-six. Crossing to the mirror I stuck out my tongue, which looked like the inside of an old kettle. I stared down my throat, but found I couldn’t see very far. Opening my shirt, I ran a stethoscope over as much of my chest as possible, and discovered that listening to your own breath-sounds for the first time is as alarming as hearing a record of your own voice. After thinking for a few minutes I decided that it must be typhoid fever.

Another characteristic of doctors is never allowing themselves to be ill by half-measures. In the process of self-diagnosis they think first of all the fatal diseases, next of the most outlandish, thirdly of the most uncomfortable, and finally reach a decision which would have had them thrown out of any qualifying examination in the country. Failing typhoid, I suspected glanders, psittacosis, or incipient cholera, and remembering the light-hearted way in which we manipulated dangerous bacteria in the laboratory I threw in rabies and plague as well.

After diagnosis comes treatment, and fumbling in my shaving locker for some white tablets which I thought were aspirins I swallowed a few. A further peculiarity of the physician healing himself is a wild disregard for labels and dosage: men who terrify patients by repeating sternly “Not more than two teaspoonsful after food” treat their own complaints largely with the pharmaceutical samples sent from drug manufacturers, in doses of either a moderate handful or a large swig. Feeling afterwards that I should call for professional advice, I picked up my bedside telephone and rang my friend Grimsdyke, who was working as a resident anaesthetist in the operating theatre.

“I’m ill,” I told him, describing my symptoms. “What do you think I should do?”

“Go and see a doctor.”

“Look here, this isn’t a laughing matter. I feel terrible.”

“Seriously, old lad. Get one of the house physicians. I don’t know much more about pure medicine than I do about pure mathematics. We live in an age of specialization, don’t we? Must get back to the theatre now – Patient looks a bit blue.”

I then rang Hinxman, houseman to Dr Pennyworth, the St Swithin’s senior physician.

“You’ve probably got the measles,” he said cheerfully on the other end of the line. “There’s a lot of it about at the moment.”

“I’ve had it. A most nasty attack when I was six.”

“It’s quite possible to get it twice, of course. And it’s usually much worse the second time. Or it might be mumps. You know what that leads to, don’t you?” He roared with laughter: fellow-doctors show as little sympathy for each other in trouble as fellow-golfers. “It’s a bit of a nuisance, because we’ve hardly got a spare bed in the ward. But I’ll pop along and see you when I’ve got a moment.”

Hinxman appeared an hour or so later. He was a red-faced, curly-headed young man much given to tweeds and pipes, who always entered a room as though coming from a brisk tramp across open moors on a gusty day. I found his aggressive healthiness deeply depressing as I nervously watched his broad pink hands pummel my abdomen.

“Deep breath, old man,” he commanded. He frowned.

For the first time I realized how alarming a doctor sounds when he goes “M’m”.

“Think I can get a touch of the spleen there,” he added.

“Good Lord!” I jumped up. “It might be one of those horrible leukaemias.”

“Yes, and it may be the chlorotic anaemia of young virgins. Don’t get excited about it. I haven’t felt a spleen for weeks, anyway, and I’m probably wrong. I’ll get old Pennyboy along when he looks into the hospital at six. Meanwhile, go to bed.”

“Bed?” I protested. “But I don’t really want to go to bed. I hate lying down doing nothing.”

“My dear chap, you must. The first thing any physician does is to put his victim to bed and tell him to keep quiet. It doesn’t do the patient the slightest harm, and it gives everyone time to think. Why, we’ve had some of our patients in bed for weeks upstairs while we’ve been thinking. We’re not like surgeons, you know – never happy unless they’re doing something violent.”

Dr Pennyworth himself came to my room that evening, followed by Hinxman and his medical registrar. The hospital’s senior physician was a small, thin, pale man with two tufts of grey hair jutting over his ears, dressed in a black jacket and pin-striped trousers. He was so quiet and so modest that he seemed to enter the room like a ghost, without using the door. He stood by my bedside, softly wished me good evening, perched a pair of rimless pince-nez on his nose, and inspected me through them in silence.

“Ever been in India?” he asked mysteriously.

“No, sir.”

“H’m.”

After some moments’ thought gently took my hand and stood staring at my nails. This I recognized as the manner of a true physician: a surgeon would have burst into the room, pummelled me briskly, exclaimed “Does it hurt? Where? There? Don’t worry, old fellow, we’ll have it out!” and telephoned the operating theatre. Dr Pennyworth silently listened to my chest, scratched the soles of my feet, pulled down an eyelid, shook me by the hand, and after a whispered discussion with his assistants disappeared as softly as he came.

As no one had told me what was wrong, I lay staring at the ceiling and speculating on the further possibility of malaria, cerebral abscess, and
spirochoetsis
ictero-haemorrhagic
. I had almost given myself up for lost by the time Hinxman reappeared.

“You’re to be warded, old man,” he announced cheerfully. “I’ve fixed everything up. Just slip on a dressing-gown and wander up to Honesty when you feel like it. Try not to breathe on too many people on the way, won’t you?”

“But what have I got?”

“Oh, didn’t we tell you? Look at your eyeballs.”

“Good Lord!” I exclaimed, turning to the mirror. “Jaundice.”

“Yes, you’d pass for a good-looking Chinaman anywhere. I’ll come and see you later. By the way, we’ll be needing a contribution for your own laboratory.”

Collecting my toothbrush, I obediently left the residency for the main hospital block and made my way upstairs to Honesty Ward. I had rarely been ill before, and I had never been in a ward in a subjective capacity at all. I now approached the experience with the feeling of a judge mounting the steps to his own dock.

“Well, well, fancy seeing you,” said the staff nurse, a motherly blonde I had once met at a hospital dance. “Sister’s off, so I’ve put you in the corner. You’re not terribly infectious, and we’ll have you on barrier nursing.”

I got into the white iron bed, which was ready with hot-water bottle in knitted cover, red rubber sheet next to the mattress, back-rest, air-ring, and a small enamel bowl on the locker in case I wanted to put my teeth in it.

“Sorry we can’t have you in a side-room,” she apologized. “But they’re both in use. One might be free in a few days,” she added significantly, “and you can move in then.”

My first few days as a patient were delightful. My disease wasn’t serious – though I kept remembering the nasty phrase in one of my textbooks, “a small percentage of cases are fatal” – and it had the advantage that no treatment whatever was known to medical science. This left my days and nights undisturbed by having to swallow oversized pills or having to tolerate over-used needles. All I had to do was lie on my back and get better.

But I soon realized that being ill in a modern hospital is far from a passive process. A few years ago it dawned on physicians that patients shouldn’t be allowed simply to rot in bed, but should be provided with daily exercise for both body and mind. This idea is now applied so enthusiastically and ward routine has become so strenuous that only people of a basically sound constitution can stand it.

Our day, like the Army’s, started at six-thirty with a wash in tepid water, and continued almost without a break until lights-out at nine. Apart from the regular upheavals caused by bed making, meals, hot drinks, blanket baths, temperature-taking, visits by the doctors, and the distribution of “bottles”, there always seemed to be some hospital functionary waiting to see you. Each morning there appeared a blonde girl looking like a Wimbledon champion in a white overall, who came from the Physiotherapy Department to conduct a horizontal PT class. When we had flexed our knees and twiddled our toes in unison under the bedclothes, another girl arrived from the Occupational Therapy Unit with a basket of felt scraps for making pink bunnies. Afterwards came the hospital librarian to see if you felt like reading, the hospital dietitian to see if you felt like eating, and the hospital chaplain to see if you felt like death. Next appeared the man who brought the post, the boy who sold the newspapers, and several women with brooms who swept under the beds and carried on a loud conversation between themselves about everyone’s illnesses. If you still had time, you could explore the arid stretches of the morning and afternoon radio programmes through the headphones, or swap symptoms with your neighbour. There was a welcome period of enforced sleep after lunch, but this was generally disturbed by fifty students clattering in for a ward-round or one of the medical staff appearing to examine you to test some private theory. Later, those of us allowed up sat round the empty fireplace stroking the ward cat, smoking our pipes, and exchanging opinions in a tranquilly companionable atmosphere reminiscent of an old men’s home.

It was in these circumstances that I first fell seriously in love.

She was the new night nurse on Honesty Ward. She was a pretty, pale girl, with large dark eyes and thick curly hair on which her official cap perched ridiculously, like the top of a
vol-au-vent
. She had a playful way of looking at you when she spoke, and the first words she addressed to me – “Would you like Horlicks or Ovaltine?” – sent odd sensations running up my spinal cord.

I had then been in the ward five days, the time I later learned from other nurses at which young men confined to bed start becoming amorous. Physicians perhaps overlook that patients’ feelings towards sex, like their feelings towards beer and tobacco, are not automatically held in abeyance while enjoying the benefit of medical care in hospital. Seeing the same half a dozen young women regularly all day naturally concentrates the invalid’s thoughts on any one of them, which has led many a convalescence to run concurrently with a honeymoon. The patient’s state is probably exacerbated by the nursing tradition of twice daily “doing the backs” – that is, massaging the lower spine with surgical spirit as a precaution against bedsores, which I understand is the method used to encourage recalcitrant bulls in the Argentine.

It was clearly worth making the night nurse’s closer acquaintance. As soon as the ward was dark, the flowers had been removed, the day nurses had gratefully reached for their corridor capes, and sister had left for the modest evening pleasures of the sisters’ home, I felt for the dressing-gown in my locker and crept out of bed.

She was in the small kitchen just outside the ward, starting to butter a large pile of bread for the patients’ breakfast.

“Hello,” I said.

She looked up. “Hello. But shouldn’t you be in bed?”

“I just thought I’d like to establish social contact as well as our professional relationship.”

Stretching her apron, she gave me a curtsy. “I am indeed honoured, kind sir, that a second-year houseman should take such trouble with a second-year nurse. Aren’t you terribly infectious?”

“Not much at this stage. Anyway, I’ll be frightfully careful not to touch anything. I’m afraid that I’ve just forgotten your name, Nurse – ?”

“Florence Nightingale.”

I laughed, but catching her eye apologized quickly. “I’m terribly sorry. Of course, there
could
be a nurse called Florence Nightingale…I mean, really it’s quite a common name, though I suppose unusual…”

“Oh, don’t worry. I’m quite used to it. My mother was desperately keen on the Red Cross. Hence the name. Hence the career. My friends call me Sally, by the way. But oughtn’t you really to stay in the ward?”

“You’re not worried about the night sisters, are you? They won’t be on the prowl for hours yet.”

“Ah, the night sisters! ‘How now, you secret, black, and midnight hags! What is’t you do? A deed without a name?’”

“You must be the first nurse I’ve ever heard quote Shakespeare on duty,” I said in surprise.

She went on buttering a piece of bread with a faintly aggressive air. “You housemen! You seem to think we confine our reading to Evelyn Pearce’s textbooks and the Engagement column in the
Telegraph
. Didn’t you see me when the Dramatic Society did
As You Like It
?”

“No, I’m afraid I missed that one,” I confessed. But seeing a common interest in sight I continued warmly, “I was terribly keen on the Dramatic Society myself. When I was a student and had more time.”

“I know. I saw your last appearance. It was the week I arrived as a new probationer, and I’ll never forget it.”

This was perhaps unfortunate. My dramatic career at St Swithin’s had reached its climax with the hospital production of
The Middle Watch
, in which I was cast as the Commander. At the start of the second scene the Captain, played by Grimsdyke, was to be discovered alone in his cabin turning over the pages of
The Field
, until interrupted by a knock and the appearance of Tony Benskin as Ah Fong the Chinese servant. Unfortunately I had mistimed the length of the interval, and Tony and I were still drinking pints of beer in the King George when the curtain rose. There being no knock, Grimsdyke anxiously scanned the entire
Field
, throwing imploring glances into the wings. He then thumbed his way through the
Illustrated London News
, the
Tatler
, and the
Sphere
, and finished the
Sketch
and
Punch
before striding off the stage in a fury and bringing down the curtain, leaving the audience mystified for the rest of the evening at the significance of this short but powerful scene.

“Are you sure you’re feeling quite well?” Sally Nightingale continued, interrupting her slicing and laying a hand softly on my cheek. “You certainly
do
seem a little warm.”

I was just reflecting how much pleasanter this was than having a glass-and-mercury icicle tasting of Dettol rammed under your tongue, when the door opened and Hinxman walked in.

“What are you doing here?” he said immediately.

“Oh, hello, old man. Yes, I know I should be in bed by rights. But being in the trade I thought I could take a few liberties with ward routine.”

“Routine? It’s nothing whatever to do with routine. It’s a matter of your treatment.”

“Have you met our new night nurse?” I asked.

“I know Nurse Nightingale very well. She was on day duty here until last week. Good evening, Sally.”

“Good evening, Roger.”

“Oh, I’m sorry,” I apologized. “I didn’t realize you’d met.”

There was a silence, in which I felt that my professional adviser and colleague was behaving oddly. Hinxman was one of those enviably uncomplicated men who sing in their baths and never have hangovers or catch colds or feel draughts, and he had the most amiable personality in the whole resident staff quarters. We had previously enjoyed a friendship which ran to mutual loans of razor-blades and textbooks, but now he was breathing heavily and staring at me as though I were some particularly striking specimen in a bottle in the pathology museum.

“Well, you’re the doctor.” I shrugged my shoulders, remembering that many young housemen appear weighty when first testing the delicate balance of the doctor-patient relationship. I decided to obey graciously, and said lightly to Sally Nightingale: “Good night, Nurse. I’ll get back to my little waterproofed cot. If I’m still awake, come and talk to me when Dr Hinxman’s gone.”

The next morning the motherly staff nurse hooked my treatment board to the foot of my bed. “You’re on complete bed rest,” she announced.

“Oh no!”

“Yes, Mr Hinxman’s written you up for it.”

“But what on earth for? I’m getting better. Why, I ought to be out of hospital completely in a few days.”

“I really don’t know, I’m afraid. Ours is not to reason why, but to do what the houseman tells us.”

My annoyance came less from the prospect of immobility than the threat it held – bedpans. These traditional features of the hospital scene, which defy the laws of geometry by possessing length and breadth but not depth, have never had, nor deserved, a word written in their favour. So far I had escaped them, but from now on I should have to catch the eye of the junior probationer like everyone else. I decided angrily to tackle Hinxman on his line of treatment as soon as he appeared.

“Look here,” I complained. “I must say, this bed-rest business is about the limit. Why, I’m pretty well convalescent! Or have you just got me muddled up with someone else?”

Hinxman stared at me in silence. His face was pinker than ever; his eyes were heavy and bloodshot; his hands were thrust deep into the pockets of his white coat, among the percussion hammers, tuning-forks, and other little diagnostic toys beloved by physicians.

“You are at liberty to complain to the Chief about my treatment if you want to.”

“Oh, I wouldn’t want to go as far as that. After all, we’re both in the trade. I know doctors make rotten patients, but I’m prepared to do as I’m told. I just can’t see the point of it, that’s all.”

Expression for a second played on his face like the top of a milk saucepan caught at the boil. Then he turned and strode down the ward, with the step of a man finding things too much for him.