Jubilee (16 page)

And now she’s throwing up and it might be nothing, the luck might run her way this time, or it might be cardiac failure.
What does it mean?
her mother asks, and Satish reminds himself that the question is a medical one.

‘It’s relatively common in recovering patients,’ he tells her. ‘Jess’s bloods and ECG look fine.’ He looks at Jess, folding the sick bowl in half, making it into a mouth she then opens and closes. No breathlessness. ‘I’m just going to examine you now,’ he tells her. ‘Is that all right, Jess? I’m going to listen to your chest and feel your tummy.’ She nods her assent and Clare helps her sit forward. Beyond the closed curtains, someone laughs.

Jess has the remains of a temporary tattoo on her back. He can’t make out what it once was – it’s all black spikes and fragmented edges.

‘Breathe in and out for me, Jess. Nice and deep, if you can.’

He imagines Jess at a sleepover with her friends, like the ones Asha has. It’s always been a mystery to him, what they do once the bedroom door is shut, but surely it’s things like this, putting tattoos on each other, giggling together. No creps; her lungs are clear.

‘That’s all fine, Jess. Just your tummy now. I’m going to need to press on it.’ He nods at Clare.

‘I feel a bit sick,’ says Jess. Her mother whips away the bent bowl and puts a new one in her hand. Clare strokes her back. They wait. Kawther runs her fingers along a fold of her hijab. Satish notices the repeated print on the material: lines of red-scarfed teddy bears.

‘It’s OK,’ says Jess after a while. ‘It’s gone.’

Clare lies her flat and pulls up her gown, resettling the sheet over her hips. Satish rubs his hands together, warming them. ‘I’ll try not to push too hard,’ he says.

His fingers press Jess’s abdomen, up towards the lower edge of her ribs: nothing. ‘Take a deep breath,’ he tells her, and then he can feel the edge of her liver, only just: thin and firm.

‘That all feels quite normal,’ he tells Jess.

‘So, what does that mean?’ her mother asks.

‘It means there’s no sinister cause for Jess’s sickness. It’s not very pleasant for you, I know,’ he tells the girl. ‘But we can do something about it. I’m going to give you some medicine to stop you feeling sick. See if we can get you eating again. Clare?’

‘Yes?’

‘IV Metoclopramide, 50 milligrams.’

‘So can she go home?’ says Jess’s mother.

‘I’m going to suggest we keep her in for a little while longer. I know it’s a disappointment, but I just want to be cautious. We’ll leave her a couple of days, reassess on … umm … Friday.’

On hearing this last word Jess’s mother slumps at the shoulders but she nods. ‘Of course, absolutely – whatever you think, really.’ She drops her voice. ‘Just, it’s hard. You know, I’m not complaining. My other kid’s at home, pillar to post. Got to find another few days’ care for her.’

Satish looks at the clock: he has a meeting in fifteen minutes and needs a pee before that.

‘Are you worried about this? Will it stop her getting better? You just said you were happy with her heart. I don’t understand …’ Her fears come in a rush, as if they’ve been racing to reach her and have just caught up.

‘It’s not optimal,’ he says carefully. ‘But it is very common. I
am
happy with her, cardiovascularly. I just need to make sure that when she goes home, she continues to make a good recovery. I’m sorry. We really do have to wait a little longer on this one.’

Alice Roberts looks out of the window again. He sees her hand go up to her face.

‘You could go home for a night or two,’ Clare says, moving closer to her. ‘We have some fairly expert babysitters at Central Children’s. Medical degrees and everything.’

‘No,’ Alice says to the window. ‘But thanks anyway. I couldn’t leave her on her own. We’ll be fine.’

Satish leaves, nodding his thanks to Kawther. A few steps away, and Clare is beside him.

‘That Metoclopramide,’ she says. ‘Just wanted to check. You did say 50mg?’

‘Yes. IV.’

‘Fifty?’

He thinks. Fifty?

‘No! Fifty? No. I didn’t say that. Five. I said five.’

‘OK.’

‘I said five.’

‘I’ll give her five.’

‘I said fifty just then because you did. But before, I said five. Definitely.’ Fifty would cause overdose and loss of muscle control, the patient twitching and jerking, her face contorting. He’d never have said fifty.

‘OK. Five.’

‘And get Jane Oshodi to see Mrs Roberts. She needs patient liaison. She’s under a lot of stress.’

At university, Satish had a housemate called Lawrence Potten, an English student for whom Satish’s chosen profession seemed an ideological and pharmacological goldmine. Pharmacologically, he had it all worked out: wait until you’re filling in for a houseman, doing ward rounds with one of the more distractable nurses. (Lawrence was, he assured Satish, an expert in distractable nurses.) Swipe some Co-Proxamol from the drugs trolley, sell it on and receive a nice little supplement to your student grant. Satish had refused, of course, but Lawrence’s plan was so accurate, and so very precise, that he knew it came from insider knowledge. Who were these
other
medics, he’d wonder, these swipers of drugs, these corrupters of youth? What sort of doctors would they turn out to be?

Lawrence had more luck with the ideological aspect of Satish’s job. In particular, he was obsessed by the cultural significance of the white coat. He considered its semiotics, its effect on interpersonal dynamics. One day, Satish noticed that his coat and stethoscope had gone from their peg on the back of his door. Two hours later, Lawrence returned with them.

‘Bloody unbelievable!’ he told Satish. ‘Incredible!’ Satish caught a waft of Lawrence’s aftershave as he bounced closer. His spiked hair juddered with enthusiasm.

‘Lawrence, what did you do?’

‘I went to the hospital! I walked through the corridors wearing it. Even a couple of wards.’

Satish winced. ‘That’s completely irresponsible.’

‘It was
fine
. It was a revelation! It’s like being Superman, isn’t it? You walk past a group of people and they turn to you, they lift their faces to you. They’re hopeful. They think you’re going to solve their problems.’

For some reason this threw a switch in Satish. ‘I do solve their problems!’ he remonstrated. ‘That’s the point! What do you think med students
do
, Lawrence?’

‘I just said—’

‘You did a stupid, irresponsible thing. Stay out of my room. Don’t take my stuff without asking. Don’t do that again.’

Lawrence retreated. ‘I just wanted to see. I thought it was amazing,’ he said. ‘Amazing, walking round like that all day.’

And of course, he was right. It
was
amazing. Even in those first sweaty weeks on the wards, when he didn’t know his otoscope from his elbow, the white coat was transformative. It was magic, a cloak of visibility, and it didn’t just make people notice you, it made people
need
you.

A couple of years after he’d started at the hospital the board had looked at ways of making the place less formal. Plenty of paediatric centres had abandoned white coats by then, and there was an enthusiastic lobby for Central to follow suit. Satish remembers his own arguments for retaining them. He’d cited studies and anecdotal evidence, suggesting that they were a comfort to anxious parents. He’d pointed out the practicalities. He lost.

When Satish walks the corridors of his hospital – as he does now, leaving Butterfly ward and heading for the lift – he operates without the benefit of his white coat. He wears a stethoscope and an ID card around his neck and carries a file in his hand, all of them vestigial, all of them what is left after the removal of that comforting, archaic costume. Around him patients, and the parents of patients, look up momentarily as he passes by, scanning him for evidence. He can see them checking his face, his ID, lingering on the folder he carries as if it might pertain to them in some way: contain news that’s been longed-for, or dreaded. He avoids eye contact, always aware of the proximity of the next thing he has to do.

When the lift doors open, Mike Halloran gets out. ‘Satish! Departmental meeting Thursday!’

‘Yes. I got the memo.’ Behind Mike, the lift is emptying. Soon the doors will close again, and Satish will have to wait.

‘It’s a lateish one.’ Mike’s a fly-boy, like all cardiac surgeons: crack one chest and you think you’re God. Talented though. All the women have crushes on him.

‘Don’t worry. I’ll be there.’ He really needs to get upstairs, but Mike’s still in front of him, hands in pockets. The lift doors slide shut. Satish wonders if he’s meant to make small talk at this point, a sort of how’s-the-wife-and-kids, like he hears the other doctors doing.

Mike says: ‘Heard about Bill Mezrich up at St Agnes?’ So: small talk, then.

‘No.’

‘Fired.’ Mike raises his eyebrows knowingly. Satish is meant to ask why.

‘Why?’

Mike grips an imaginary glass and shakes it in front of his face. ‘Booze. On the sauce. Went into theatre pissed.’

‘That’s … that’s terrible.’

‘Anaesthetist halted the op.’

‘Oh, God. Poor Bill.’

Mike frowns. ‘Poor Bill? Satish, he went in there
pissed
.’

‘I know, but still …’

‘Sat next to him at a conference once. Like being in a bloody brewery. All the stories will come out, now that he’s gone.’

‘Mike, can I …?’ Satish needs – very badly – to get away. He gestures at the lift.

‘No problem. On my way.’ But he hesitates. ‘Some of us will probably be going to the Duke for a drink afterwards. If you wanted to come …’

All the stories will come out
. Satish, stripped of his medical props and sitting at a pub table. Satish with all his protection missing, the job, the urgency, exposed amongst them and looking for safe things to say.

‘I don’t know. It depends what time …’

‘Yeah, I know. Well, if you want to. Push the boat out.’ He grins and walks backwards, away from Satish, who reaches out for the lift call button and presses it.

‘All right. I’ll see you at the meeting.’

Mike swivels on his heel and walks away, lifting a hand in valediction.

Satish waits for the empty lift, the private space. Sometimes, simply staying upright feels exhausting. There is a need, now, to comb over the details of that last conversation, to check for the subliminal nod and wink. What does Mike know? What has he guessed? But Satish is denied even these few moments of privacy, because when the doors finally open there’s a woman waiting beside him to get in. She struggles with a buggy, her baby balanced in the crook of her elbow. Satish recognises the awkward stance: this child has had recent heart surgery, and can’t be picked up under the arms. He moves to help her, pulling the buggy into the lift behind them.

‘Thank you so much.’ He presses the button for his floor, asks her for hers. She’s tall and bony, well groomed, a contrast to the frazzled mothers who have to make do with hospital bathrooms for their morning ablutions. For some reason he isn’t predisposed to like her, he finds, and he’s trying to work out why when she frowns at him and glances down at his ID.

‘Satish?’ She says it quietly. And suddenly he’s looking at Sarah again.

The doors haven’t quite shut yet. There’s still time. He takes a single stride across the floor but as he does they close. There’s a view of the corridor, a shrinking vertical slot, then just metal, and they’re shut in together.

‘I didn’t know you worked here,’ she says.

He doesn’t answer her. His hand moves up to stroke his scalp through his hair and then he stops himself doing it.

‘You’re a doctor here?’ she says, hesitant.

He can hear his breathing coming faster and he wonders whether she can hear it too. He can’t find a comfortable place for his hands: folded across his chest, in his trouser pockets, resting by his side, they migrate away from wherever he puts them. He looks briefly at her and knows from the concern on her face, from her own indrawn breath, that she’s about to say something far more perilous than small-talk.

‘Yes,’ he puts in quickly. ‘I’m a cardiologist.’

‘Oh!’

He’s silenced her. Five floors of this, he tells himself. Just five more floors. He watches the red on the buttons flick upwards as they climb.

‘This is Louis,’ she says. ‘He was born with Fallot’s.’

He looks at the child. At maybe seven months, the boy’s a little too old to be happy on his back and he flails for an upright position.

‘He was fine. Well, we thought he was fine. Then our GP heard a murmur.’

She’d have had an apparently perfect baby. The paediatrician would have done an echo to look inside that perfect chest, not yet assaulted by a sternal saw, no ridge of scarring down its centre, and seen an imperfect heart twitching in the darkness, the misdirected blood flashing Doppler blue amongst the red.

On the third floor, the lift bounces to a stop and the doors open. Satish retreats to the opposite corner, waiting for incomers. There’s silence from outside. After a moment Sarah leans out: ‘False alarm,’ she tells him, and just as Satish realises he could nip out himself, the doors close again.

‘Nancy Driscoll operated last month,’ she says. ‘This is our four-week check. Is she good, Nancy Driscoll? We googled her. She seems to be good.’

‘Yes. Nancy’s very good.’

‘They gave us Suraya Ahmed as a cardiologist. We hadn’t even thought about that, about a cardiologist, or about the care he’d need afterwards – honestly, you just hope there will be an
afterwards
– so we hadn’t looked her up or anything. What’s she like?’

‘Suraya’s excellent.’ He hesitates. ‘Everyone here is excellent.’

The lift has bumped gently to a halt. Finally, it’s her floor. As she rolls out the buggy she asks him, ‘Are you going to do this photograph?’ but he steps back into the lift without answering her. She gives him a tight smile as the doors close, and then she’s gone.

Her Saturday mornings were usually spent with Mandy. They’d call round for each other about ten: enough time for a lie-in, for Mum to nag her to
get up, you’re wasting the day!
She’d have a long soak, nick some of her mum’s bubble bath and lie there in the suds reading
Jackie
or
Pink
, shouting at her dad when he wanted to come in. Then she’d spend half an hour getting dressed, trying on different things in front of the dressing-table mirror; she liked to wear nice things on Saturdays, even if she and Mandy ended up doing nothing special, just hanging around in each other’s bedrooms.