Relative Ethics

‘They’d probably line up to be nibbled by you. They’re a miserable collection of rakes, by and large, but good doctors nevertheless. Just don’t let them take themselves too seriously!’

He wheeled her down the corridor and into the staff lounge. Forewarned was forearmed, she thought as the two young men lolling in the chairs raised bleary faces to her and then stumbled to their feet, interest flickering in the sunken depths of their bloodshot eyes. How tired would they have to be before they failed to register a reasonable-looking woman? Bron wondered, and tried not to laugh at their enthusiasm as they squabbled amicably over who was giving her a cup of coffee.

It turned out to be academic because the loudspeaker on the wall squawked as they reached the coffee-pot, and they groaned and tossed a coin.

‘See you later,’ one of them grumbled, grabbing his white coat off a peg, and Jim waved at his retreating back.

‘That was Steve Barnes. This——’ he indicated the other doctor, who had forgotten about Bron’s coffee and slumped back down in a chair ‘—is Mick O’Shea.’ The loudspeaker squawked again, and Jim excused himself with a mild expletive and a muttered apology.

Bronwen crossed to the coffee-pot. ‘Hello, Mick. I’m Bronwen Jones. Can I get you a coffee?’

The Irishman raised his head and stared through her for a second, then forced his eyes to focus. ‘Thanks. That’d be great. What a bloody awful night!’

‘Grim, was it?’

He nodded, and sat up to take his coffee from her, gulping it gratefully. ‘So tell me, Bronwen, what’s a pretty little slip of a thing like you doing in a hell-hole like this?’

Bronwen laughed. ‘One, I am not a pretty little slip of a thing—I am at least three years older than you, Dr O’Shea—and I’m here to work, and two, it’s not a hell-hole, it’s a well-run, modern hospital in an idyllic setting.’

‘Well, it sure feels like hell this morning, and as for your being a whatever it was I said you were, I reserve judgement—even if you’re positively middle-aged!’

Bron shook her head and tried to look severe, but Mick’s eyes were closing again and his half-finished coffee was taking a nose-dive down the front of his shirt.

She caught it in the nick of time and eased his fingers from the handle of the mug. Mick murmured something unintelligible, and slid further down the chair, out for the count.

Finishing her coffee, Bronwen made her way out of the staff-room and out into the corridor off which opened the treatment-rooms. Middle-aged, indeed! Sometimes she still felt eighteen, young, shy and innocent, and the world seemed a terrible place, full of people tempting her with lies and platitudes; she shook her head and pulled herself together as Steve Barnes came out of one of the treatment-rooms with a laughing nurse at his side.

‘Ah, Dr Jones, I take it you got your coffee?’ he said with a grin, and stuck out his hand. ‘Steve Barnes, and this is Sister Hennessy—Kathleen.’

She shook the proffered hands, and introduced herself as Bronwen. ‘I left Mick crashed out on the chairs in the staff-room—he looked all in.’

Steve shook his head. ‘He had a bad night—lost two of his patients in the space of an hour. It’s his first SHO job; he only started on A and E four weeks ago, and he hasn’t got used to it yet.’

‘Do we ever?’ Kathleen asked drily, and Steve laughed shortly and without humour.

‘Point taken. I’m going up to breakfast—I’ll dig Mick out on my way. Nice to meet you, Bronwen.’

Kathleen gave Bron a steady look, and smiled. ‘Welcome to the madhouse,’ she murmured. ‘Come with me and have a look round—have you worked in A and E before?’

‘Yes, in Bristol, but not for eighteen months.’

Kathleen twitched back a curtain across a treatment-room door and folded a blanket on to the foot of the bed. ‘This is where we treat the walking wounded,’ she explained, and opened the door at the far end of the room. ‘The cubicles are open to the waiting-room through a door, and through the curtained opening to the corridor, so that we have access from both sides. It means that seriously ill patients aren’t treated or moved in view of the waiting area, which is a fantastic improvement on where I trained.’

She opened another door. ‘This is the plaster-room, and X-ray is opposite, with Orthopaedics through there, so it’s all very convenient. Surgical and Medical wards are the other way, Paediatrics upstairs, and Obs and Gynae are in another wing—quite a trek, but they tend to be admitted direct. And in here is the emergency treatment area for acute and cardiac cases. In our more pompous moments we call it the trauma unit! OK?’

Bronwen was quite definitely not OK. Confused, bombarded with facts, names, unfamiliar geography, and all on top of doubts about returning to work. She shook herself and straightened.

‘Where do I leave my bag, and what about a white coat?’ she asked.

‘See Jim. He’s in his office. Come and find me when you’re all set up—and don’t worry, you’ll soon get back into it.’

She grinned and walked away with the quick, businesslike stride of the professional nurse, quiet and no-nonsense. Bron had warmed to her on sight, and knew instinctively that the sister would do everything in her power to help her settle in.

With a sigh of relief, she made her way to Jim Harris’s office. Just as she was turning the corner, she heard a deep, masculine laugh that shocked her to her toes. It couldn’t be! Bron gave herself a little mental shake. She really must stop doing this, seeing him and hearing him in every tall, fair man she had seen for the past two years. Nevertheless, as she rounded the corner, she couldn’t prevent her eyes from scanning the corridor eagerly, nor could she prevent the ridiculous little stab of disappointment when he wasn’t there.

Ten minutes later, equipped with a bleep, a white coat and a locker key, she found herself plunged in at the deep end with an elderly man suffering from chest pain and acute breathlessness. She listened to his chest, and smiled and chatted while she took a history and observed him.

‘Do you find it easier to breathe sitting up? Yes, I thought you might. All right, Mr Davis, you just sit there like that for a minute or two and breathe nice and steadily through the oxygen mask, and I’ll get someone down to look at you.’

She detailed a nurse to stay with him, and found Kathleen Hennessy checking dressings in one of the other cubicles.

‘There’s an elderly man in three with what looks like LVF, but he’s in too much pain, and I don’t like the sound of his chest. Can we get someone to look at him?’

‘I’ll get the consultant down.’ Kathleen crossed to her desk and picked up the phone. ‘Dr Marumba, please.’

Bron, her face troubled, went back to her patient. He was, if anything, even more distressed, but she was reluctant to give him anything before Dr Marumba saw him, so she checked his pulse again and found it light and fast. His skin was damp, and he was obviously deteriorating rapidly.

She stepped out into the corridor again and looked up and down for any sign of another doctor.

Kathleen came up to her. ‘His wife’s here—do you want to talk to her?’

Bron nodded. ‘Yes—is there somewhere we can go?’

Kathleen showed her into the office and then moments later came back with a worried-looking woman in her late sixties.

‘Mrs Davis? Is there anything you can tell me about how your husband’s been feeling recently that might help us?’

‘Oh, Doctor! He’s been off for weeks—hasn’t wanted his food, and he’s never been a picky eater. Complained of his feet swelling, and feeling breathless, and yesterday he was sick again—then this morning I thought he was better, because he went out into the garden and picked some strawberries for breakfast. He’s been in the garden a lot recently, that’s how he’s got that lovely tan, but he hasn’t looked well, and the backache——’

Bronwen leapt up. ‘Thank you, Mrs Davis. That’s been most helpful. I’ll get a nurse to take you back to the waiting-room.’

She all but ran back down the corridor to the treatment room.

She took the nurse to one side. ‘How is he?’

The girl shrugged. ‘Not good. Chest pain seems to be worse. I’ve put him on a monitor.’

Thanks. Taken any bloods? I think we need a total chemistry and blood count. It might be his heart, but I’m putting my money on renal failure.’

‘May one ask why?’

At the sound of the impeccable Oxford accent, Bronwen turned and looked up—and up.

‘Dr Marumba?’

He clicked his heels and inclined his head with a slight smile. ‘Call me Jesus. Everybody does. You were about to tell me…?’

While he ran gentle but thorough hands over the frail patient, Bron repeated the symptoms—nausea, vomiting, backache, breathlessness, oedema, chest pain, and also the all-over suntan—and then delivered the coup de grâce.