Ken McClure - Trauma

“That won’t please your colleague too much,” said Lafferty, remembering their earlier conversation.

“Oh, Kevin’s all right Father. It’s just that the job gets to you some times. Some of the things you see every day... you start to see things differently — well it just gets to you, you know.”

Lafferty nodded. “I know.”

He glanced at his watch as he stepped outside and shrugged his shoulders against the cold. It was eleven thirty. He looked up at the sky to see that it had cleared completely. As a consequence, the temperature was now well below zero.

At three that morning, Sarah Lasseter’s bleeper went off and she responded almost automatically. Her room was freezing as she pulled on a sweater and slacks — the hospital turned the heating in the residency off at eleven and it didn’t come on again until six in the morning. Before getting into bed she had laid all her clothes out in order so that she could dress quickly and in complete darkness if need be. She reached under the bed for the pair of flat slip-on shoes she kept there and slid her feet into them. She put on her white coat and clipped her bleeper to her top pocket before patting the other pockets to check that she had everything she needed. Satisfied, she sighed, “Off we go again,” and slipped out of her room, closing the door quietly behind her to avoid waking anyone else on the corridor.

The coldness of the air outside almost took her breath away as she crossed the courtyard from the residency to the main hospital: she had to watch her footing on the frosty cobbles as twice she nearly came to grief. It was a relief to enter through the swing doors and find herself cosseted with warmth, but she was still rubbing her hands together when she entered HTU and sought out the night staff nurse. “You rang, Master?” she joked in a deep voice when she saw the nurse approach.

“Sorry, Doctor, we have an admission from A&E.” The nurse handed over a clip-board with a single sheet of paper on it.

“John McKirrop?” exclaimed Sarah. “The same John McKirrop?”

“ ’Fraid so,” answered the nurse. “He’s really bad this time. Depressed fracture of the skull. The police think it was a bottle. He almost certainly has serious brain damage but A&E say he’s stable for the moment so they’re keen to pass the buck.”

“Poor man,” said Sarah, reading the notes. “Is he here yet?”

“He’s on the way up,” answered the nurse.

Sarah heard the lift doors open and turned to see the night porter manoeuvre out a trolley. He had to swing his body wide to counteract the wanderlust of the front wheels as he pushed it in through the primary unit doors. A nurse accompanied him.

“All yours,” said the nurse when the secondary doors had been opened to allow the trolley to enter. “Where do you want him, Staff?”

“Alpha four,” replied the staff nurse, turning to lead the way to a bay in one of the three small ‘wards’ that comprised the HTU. Each of the three patient service areas, alpha, beta and gamma, could accommodate four patients and each individual bay was equipped with life support and monitoring equipment at the leading edge of technology. At this early hour the unit was only dimly lit by night-lights, which gave off a peaceful, green glow. Sarah found that the lighting at night always made her think of an aquarium.

The three other beds in Alpha were all occupied, the patients having sustained head injuries which demanded that they have intensive care or brain monitoring or both. Each bed was surrounded on both sides by electronic equipment and chart recorders. Apart from the gentle hum of the heating and air conditioning, clicking relays decided who would breathe and when. The A&E trolley was positioned parallel to the bed and McKirrop’s body was lifted gently to its new home. The porter wheeled away the trolley followed by the nurse from downstairs, leaving Sarah and the staff nurse to deal with McKirrop.

“Let’s get him plumbed in,” said Sarah, starting to connect the first of a range of tubes and electrodes to McKirrop’s unconscious body. The staff nurse had turned on a small spotlight above the bed which provided a circular pool of white light on the patient without it encroaching on the dim green glow of the neighbouring bays. Sarah and the staff nurse worked silently until McKirrop was wired into the system and electronic information was now available for Sarah to note down on the patient admission sheet. When she’d finished, Sarah looked down at McKirrop and said, “Just how you’re still alive, John McKirrop, is a mystery to me. You must want to live very much.”

“God knows why,” said the staff nurse.

Sarah smiled as they both watched McKirrop’s chest rise and fall in response to the ventilator equipment. “Maybe he’s an eccentric millionaire?”

“Or very much in love,” said the nurse.

“Or very angry.” Sarah looked at her watch and noted down the time on the sheet. “Patient admitted to HTU and stable at three forty-six,” she said.

The nurse looked at the fob watch pinned to her apron. “Check,” she answered.

“I think that’s all we can do for the moment,” said Sarah, stepping back from the bed. “How are the others?”

“No problems,” replied the nurse. “Everyone’s behaving tonight — so far.”

“Long may it continue,” said Sarah. “I’m going back to bed.”

“I’ll try not to disturb you,” smiled the staff nurse.

Sarah had an undisturbed four hours’ sleep before she was up again to begin the business of the day. It was Tyndall’s ward-round today so Logan would be particularly edgy and anxious to ensure that the unit was running smoothly. Sarah decided on a dark pencil skirt and a black roll neck sweater. She tied her hair back in a bun. Finally, she chose to wear her large-framed spectacles with this outfit, knowing full well the ensemble would make her look like a schoolmarm — or Audrey Hepburn playing a nun, as Paddy Duncan had put it once before. Sarah deemed the measure necessary. Images were important and she intended to be taken seriously.

Tyndall’s ward-rounds always started at nine thirty precisely so Sarah was surprised when Logan was still absent at twenty-five past. She was beginning to think that she would have to brief Tyndall on her own when a breathless Logan appeared, cursing his car for having a flat battery. He smoothed his hair back with both hands and tugged his shirt cuffs down below his white coat before taking the patients’ files from Sarah’s hands without comment. Sarah watched the unit Sister and the day staff nurse exchange glances in response to Logan’s rudeness.

Logan had not had time to read more than a paragraph before Murdoch Tyndall entered the duty room dead on the half hour.

“Morning everyone,” said the smiling consultant whose eyes moved quickly round the room taking everything in. Logan let the asynchronous chorus of good mornings die down before he said, “Good morning sir. All ready for you.”

Tyndall rubbed his hands together and said, as he always did, “Right, let’s get started.”

Sarah smiled at Sister Roche, the unit sister, as Tyndall led the way followed by Logan at his elbow. The rest of them followed in single file in what Sarah always saw as a feudal procession. The Lord of the Manor being shown around his policies by his retainers. They stopped at each bay in turn and Logan read from the case notes, which he hastily referred to for values and figures. Tyndall would nod and ask questions either of Logan or the nursing staff. Questions regarding nursing care were relayed through Sister Roche who would answer herself or refer the question as she saw fit.

When the group arrived at Alpha 4, the bay where McKirrop lay, Logan became flustered. He thumbed his way through the papers in his hand without finding what he was looking for. “This is...” he began.