Ken McClure - Trauma

The consultant in charge of the Head Trauma Unit, Doctor Murdoch Tyndall, was the very model of good breeding and manners, a charming man in his fifties who looked as if he might have auditioned successfully for the part of an aristocrat in a Disney film. His appearance was complemented by a formidable reputation for his work with brain-damaged patients. But despite his professional success, it was eclipsed by his brother’s achievements. Cyril Tyndall was a professor of viral epidemiology at the university medical school and a world authority on the design and development of vaccines.

Although the Tyndall brothers worked in different areas of medical research, Cyril Tyndall’s success in the development of animal and human vaccines had had a direct effect on his brother’s work. Gelman Holland, the pharmaceutical company which made a great deal of money from manufacturing Cyril’s vaccines under licence, had not only endowed the medical school with substantial sums to provide the best facilities for Cyril to continue his work — a strictly commercial gesture — but had also made a further grant of two million pounds to the teaching hospital. This was seen by many as a high profile public relations exercise, but the company insisted that it was to emphasise their avowed commitment to front line medicine and research.

To everyone’s surprise and delight, the Gelman Holland gift had been matched by an equivalent amount from the Department of Health in the unusual form of a direct grant. As agreed by both parties, the funds had been used to set up the Head Trauma Unit at the hospital. This had been done this ostensibly to establish a national centre of excellence for the treatment of head injuries but it was no secret that they also saw the propaganda value in illustrating how well public and private enterprise could work together for the common good in the field of health care. The government clearly saw this as the way ahead. Future funding would come less and less from the public purse and more and more from the involvement of commercial interests in health care.

The HTU — or more correctly, The Gelman Holland Head Trauma Unit, although no one ever called it that — had been open for fourteen months and had already earned an international reputation, particularly in the diagnosing of degrees of brain damage thanks to special monitoring equipment, the design of which was Murdoch Tyndall’s special research interest. A consequence of Murdoch’s research commitment was that much of the general running of the HTU was left to his senior registrar, Derek Logan. This was unfortunate from Sarah’s point of view.

Sarah lived in the junior doctors’ residency at the hospital, though she might have argued that she really lived in HTU; she spent so little time in her room. She was however, due some time off now. She looked at her watch and saw that she only had another hour to do before she was relieved and would have a full twelve hours to herself. There was a patient she wanted to check on before she went off- duty. She went up to the ward and spoke to the staff nurse in charge.

The patient in question, a woman in her early fifties who had been the victim of a hit-and-run accident seven months before, was due to be discharged later in the day. Sarah felt that this was all right as long as her daughter was going to be around to look after her — as the patient herself had maintained she would be. The daughter, however, had been proving elusive. Sarah asked the nurse whether she had made contact yet and whether in her opinion the woman could cope on her own.

“Her daughter hasn’t phoned yet,” said the staff nurse. “And I definitely think she won’t be able to cope on her own.”

“I don’t know what to do for the best,” said Sarah. “She’ll be heartbroken if she doesn’t get to go home today. Maybe I should try calling her daughter’s number again.”

At that moment Derek Logan came into the duty room and, seeing the frown on Sarah’s face, asked, “Problems?”

Sarah told him what the trouble was and Logan’s lips took on a sneer. “For God’s sake woman,” he said. “You’re a doctor not a bloody social worker, Dr Lasseter. Let them get on with it!”

“Yes, Dr Logan,” said Sarah through her teeth.

“Leave it with me,” said the staff nurse kindly and Sarah nodded her appreciation.

“Yes Dr Logan, no Dr Logan, three bags bloody full Dr Logan!” murmured Sarah as she walked into the lounge of the junior doctors’ residency and threw down her bag. There were three others there, one woman and two men. They looked up.

“May we take it that you and Del boy have been having words again?” asked Harry Whitehead, a tall gangling resident with rimless spectacles and a thinning quiff of fair hair. The vertical stripes on his shirt only served to emphasise his gauntness but his voice was strong and deep.

“You may,” answered Sarah. “I can do nothing right as far as he is concerned.”

“Don’t take it to heart, Sarah,” said the other man present, Paddy Duncan, senior house officer in general surgery.

“Sit down Sarah. Take it easy,” added Louise Vernon, who was doing a residency in obstetrics and gynaecology. “It’s only for six months, remember.”

“I’m beginning to count the minutes and it shouldn’t be like that! I can remember thinking I was the luckiest medic of my year when I got the job in HTU but now...”

“Nothing ever turns out like it should be. You have to learn to roll with the punches. Forget about him for the moment.”

“Easier said than done,” said Sarah.

“We’re all going out for a Chinese meal. Come with us.”

Sarah felt cheered by the prospect. “That sounds good; I’m sick to death of stale sandwiches and stewed tea.”

Lafferty was beginning to think that Main was not going to show up. He had expected him to come some time around mid-afternoon but it was now nearly seven in the evening. He had even begun to consider what he should do next, and was deliberating over whether he should visit Main at home or whether it might not be best in the long run to let the matter drop, when John Main came into the church and made the thought redundant. He was wiping snow from his shoulders.

“Cold out there?” asked Ryan.

“Freezing,” replied Main. “Mind you, it’s not that much warmer in here. He rubbed his arms to emphasize the point.”

“I’m afraid we can’t afford to have the heating on all the time,” said Lafferty. “But we can talk through here.” He made a gesture towards the head of the church with his arm. “It will be more comfortable.”

Main followed Lafferty through a small wooden door, painted blue and set in a stone arch to the left of the pillar behind the pulpit. It made Main think of Alice in Wonderland. Once through, they turned left again and entered a small room where Lafferty’s vestments were hung on the back of the door. They were all on a single coat hook and it looked overloaded. Main was careful how he closed the door behind him lest they all fall in a heap.

There were two armchairs in the room, which looked worn and not very comfortable, placed on either side of an ancient gas fire, and mounted along the wall opposite the single window in the room were several laden bookshelves. Below the window, arched and paned with leaded glass, stood a table stacked with hymn books that looked as if they had been withdrawn from service due to their tattered condition. A series of religious paintings were hung on plain walls that were a dull cream in colour, one of the chief colours favoured by institutions, thought Main, the other being green.

Lafferty invited Main to take his coat off and to sit down while he himself knelt down in front of a gas fire and started to feed it matches cautiously as the gas hissed through. On the third attempt the fire popped into life making Lafferty withdraw his hand quickly. Even so, Main could smell singed hair. He noticed that one of the radiants was damaged; it emitted a flickering yellow flame while the others were blue.