Page 37 of The Night Shift
‘You managed to get him to go back and consent the patient again?’ Anjali spluttered. ‘And you called himsweetheart?!’
‘Well, he hadn’t consented him properly,’ said Violet, wondering if she was in for a bollocking. ‘And he did call mesweetheart, andlove, and other diminutive terms intended to make me feel inferior. I thought I’d just “reflect it back”– see, I do pay attention to some communication skills.’
Anjali hooted with laughter. ‘I sometimes wonder if we should actually teach your brand of communication skills, Violet,’ she said. ‘Don’t worry. If there’s any kick-back with Dr Corbishley I’ll handle it. Sounds like you did the right thing for the patient.’
Which is all I ever try to do, thought Violet to herself as she placed the phone back in its cradle.Just odd that it sometimes gets right up other people’s noses.She remembered back to her third year as a medical student, fresh on the wards when a different surgeon had shouted at her in front of the whole team for refusing to do a rectal examination on an elderly man with bowel cancer. The patient clearly had advanced dementia and was unable to consent to twelve students sticking their finger up his rear end just so they could feel the craggy consistency of his adenocarcinoma, so Violet had refused, point blank.
‘How are you supposed to learn about signs and symptoms if you don’t examine them?’ the surgeon had roared as he put a large cross against her name on his clipboard. ‘You need to know what you’re looking for, Miss Winters, otherwise you’ll fail to diagnose a cancer in the future and who’s going to thank you then, hey? As we always say, put your finger in it or you’ll put your foot in it.’
The rest of her classmates had tittered along sycophantically. They were used to Violet causing a scene and most of them thought her aloof and superior. They welcomed seeing her taken down a peg or two. She didn’t care. Even when she was stood in front of the undergraduate dean she refused to concede. Her own grandmother had been diagnosed with dementia a few months earlier and the thought of her being subjected to multiple distressing examinations against her will just for the purposes of furthering someone else’s education, was anathema to her. She knew she’d done the right thing. And at the end of the day, her distinction-level exam results were difficult for the undergraduate dean, or anyone else in the medical school, to argue with.
Gus
Gus’s senior registrar Karen checked the monitor and pushed the theatre stool towards him indicating for him to sit down.
‘You okay to keep an eye on her while I just pop into the recovery room?’ she asked, inclining her head towards the anaesthetised patient lying on the operating table. ‘She’s stable and I reckon these lads have got another twenty minutes before they close. Is that about right?’ She peered down the operating table towards the surgical field and Barney Snell shrugged his agreement (which was not easy to do while holding a clamp).
‘It’s fine, Karen, of course.’ Gus wheeled himself into position behind the patient’s head. ‘You go.’
She smiled, a rare event in the life of Dr Karen Stringer, although Gus’s colleagues had pointed out that the majority of her smiles seemed to be reserved for him. ‘Give me a bleep if anything kicks off,’ she said. ‘I’ll only be next door. I just want to check how that lad with the testicular torsion is doing.’
He nodded and checked the time on the theatre clock. Half past midnight. That meant it was now Friday. It was odd how days of the week seemed to merge into one amorphous mass when you were working a series of night shifts. Especially at Christmas. He thought back to Violet’s confession the previous morning, how embarrassed she’d been by the fact that she had chosen to work the festive period and how surprised to learn that he’d done the same. Her admission had allowed him to vocalise that decision, to tell her how he had offered a swap with a colleague pleading a desperate need to be off in January instead, another lie as he had absolutely nowhere he needed to be in January either.
‘We’re both as tragic as each other,’ he’d said to her. ‘A pair of Scrooge McDucks.’ He smiled, thinking of her now, wondering which ward she was currently on and what she might be doing. He’d brought his swimming kit back into work today in case she asked him along again. It wasn’t just because he’d slept so well, although that was part of the reason. Really he just wanted to see her again, spend more time with her outside the hospital.
‘You can manage the closing sutures, I take it?’ The senior surgeon, Ranj Singh, peered over his glasses in the direction of Barney Snell who looked bored.
‘Of course, Mr Singh,’ Barney said. ‘I’ll tidy up here. And thank you for letting me do some of the diathermy. I’m sorry that I?—’
‘Nothing to worry about Mr Snell,’ said Mr Singh graciously. ‘Ruptured appendices are very vascular. She’s fine now. Crisis averted.’ He lifted his hands to his chest and backed into the scrub room.
‘Would have been fine if he’d just let me carry on,’ Barney muttered to himself once his senior colleague had disappeared. ‘I’d have easily been able to stop the haemorrhage if he’d just given me a few more minutes.’
Gus was non-committal from the head end. He’d seen the patient’s blood pressure drop precipitously during the incident Barney described and was glad that Mr Singh had stepped in when he had. But he knew that a certain amount of dick-swinging was expected in the theatre and there was no harm in letting Barney grumble while he closed the layers.
‘I’ll be done here fairly soon, Gus.’ Barney lifted his eyes from the needle holder. ‘Have you made sure I’m on the op note?’
Gus looked at the paperwork. ‘Yes, mate. You and Ranj are both down here as named surgeons.’
Barney seemed to be smiling beneath his surgical mask although it was difficult to tell for certain.
‘Hopefully that’s the last one in theatre for a few hours at least,’ said Barney, pulling the vicryl thread neatly through the woman’s subcutaneous tissue and knotting it with a flourish. ‘Although I think you’ll have a couple of pre-op assessments to do before morning. There’s a chap on ward ten, pancreatic mass. Needs an ERCP first thing.’
‘Oh, yeah, Karen mentioned him,’ said Gus. ‘Eighty-four-year-old man. Nasty looking CT scan. Mr Zeller, wasn’t it?’
Barney shrugged. ‘Can’t remember to be honest,’ he said. ‘Something foreign sounding. Eastern bloc. The only reason I mention it is that there’s some chippy bird up there on the ward who’ll rip your ear off if she thinks you’ve not consented him properly.’ He laughed but it sounded hollow.
Gus shrugged affably. ‘Oh well, a lot of the nurses up there are very protective over their patients,’ he said.
‘Oh, she wasn’t a nurse,’ scoffed Barney, ‘I’d have given her even shorter shrift if she had been. No, she’s a doctor. But only just. Foundation year, she’s probably been in post all of a month. Not that you’d know it from her attitude, acted like she was chief exec of the entire trust rather than someone straight out of med school.’
Gus felt a prickling sensation across the back of his neck. He had a horrible feeling that Barney was talking about Violet. ‘What, and she wasn’t happy about your pre-op assessment?’
‘She wasn’t happy about much of what I did, mate. Stuck-up bitch. Seems to think she can look down her nose at me. I told her I’d have a quiet word with her boss and that shut her up for about a minute– then she was off again, giving it all that with the superior attitude. That’s the trouble with these uptight academic ones, fresh out of medical school and no clinical experience, they think they know everything.’ He busied himself for a moment with a suture and then leaned in towards Gus. ‘She was nice-looking though,’ he said, his voice suggestive. ‘I can think of infinitely more pleasant ways to shut her up…’
Gus felt his fists curling involuntarily. It was clear what Barney was implying and he evidently assumed that Gus would either smile along or offer a similarly boysy comment of his own. If he remained silent then no harm done, he could easily pretend to himself that he hadn’t understood Barney’s meaning. He’d done as much in the past. But thinking about Violet led him to wonder what she would do in the same scenario. He recalled the incident with Mrs Boulter and her comments about the ‘slums of Calcutta’ a few days earlier. There was no way Violet would put up with this sort of insidious misogyny, in the same way that she wouldn’t tolerate ‘friendly’ racism. He’d seen enough of her in action to know that she would stand up for what she deemed to be right, irrespective of the damage it could do to her own reputation, career or social standing. And besides, he was already annoyed at Barney for his comments about the girl with sepsis the previous night.
‘What do you mean?’ He phrased the question innocently enough hoping to give Barney plenty of opportunity to correct himself. But no such luck.
