A Girl in a Million

Mr Wilkins gobbled wordlessly; he was a pompous man, short and stout and middle-aged. He was a splendid surgeon and the students held him in awe, something he rather enjoyed, and here was a dab of a girl actually pushing him aside, telling him to wait. The fact that if he hadn’t waited the consequences would have been unpleasant to himself cut no ice. He opened his mouth to administer a dignified rebuke, but Caroline spoke first. ‘There—Mrs Clarke is better now.’ She mopped the lady’s pallid brow and picked up the bowl. ‘I do hope,’ she added in a motherly voice, ‘that your foot isn’t painful, sir.’

She slipped away and Sister, Staff and Corinna, who had been holding their breath, let it out with a sigh of relief. Mr Wilkins looked around him but the various faces looking back at him seemed solemn. ‘We will now examine Mrs Clarke,’ he told them and embarked on a rather lengthy dissertation concerning that lady’s insides, very much to her discomfort.

Drinking his coffee presently, Mr Wilkins voiced his disapproval of Caroline’s conduct. ‘I have neither the time nor the inclination to speak to this nurse,’ he observed, ‘I rely upon you, Sister, to deal with her as you think fit. I intend to speak to the senior nursing officer, of course. I cannot have my authority undermined.’

Sister, a strict disciplinarian but always fair, spoke up. ‘Nurse acted with foresight, sir. If she hadn’t reached Mrs Clarke with the bowl you would have been—er…’ She paused delicately.

‘She pushed me,’ said Mr Wilkins crossly, ‘and trod on my foot, and then had the impudence to hope that she hadn’t hurt me.’

His registrar said quite quietly, ‘It was either that or vomit all over your suit, sir. I agree with Sister—Nurse acted promptly in the best interests of both you and your patient.’ He added, ‘It would be most unjust to blame her for what she obviously saw as her duty.’

Mr Wilkins had gone red. ‘Since I am to be outnumbered I shall overlook the matter, but rest assured that I shall make it my business to keep a strict eye on the girl. What is her name?’

‘Nurse Frisby. She has just entered her second year. She is a promising student.’

Mr Wilkins said, ‘Pish,’ and went away, his registrar, poker-faced, with him. He didn’t like his chief overmuch, and he was glad that Caroline had escaped his bad temper. He grinned at the thought of the medical students recounting the episode to their fellows. Most of them had suffered at some time from Mr Wilkins’ ill humour and would relish a good laugh at his expense.

All the same, something would have to be done about it, Sister decided, and took herself off to the office to see her superior.

Two days later, before Mr Wilkins’ next ward round, Caroline was transferred to the children’s ward.

It was a happy choice made by her two superiors. The paediatric unit was housed at the back of the hospital, a modern wing built on to the ponderous Victorian main hospital. It was presided over by an elderly woman, Sister Crump, reputedly as mad as a hatter but none the less a miracle-worker when it came to getting her little patients well again and, what was more important, keeping them happy in the process.

After the strict regime of Women’s Surgical, Caroline found it very much to her liking. Here there were no orderly rows of cots; they were wheeled here, there and everywhere according to Sister Crump’s mood, and down the centre of the long ward there were low tables cluttered up with toys, teddy bears and picture books and the children who were well enough were allowed to scamper around within reason. On first sight it appeared to be a madhouse, but there was order too, and if a nurse couldn’t fit into Sister Crump’s way of working she was moved to another ward, for she demanded meticulous care of the children in her charge. Dressings were done, little patients got ready for Theatre, temperatures taken, medicines given to the strains of cheerful music. Since the children, unless they were very ill, shouted and screamed a good deal, the nurses had to lift their voices above the din. There was discipline too: the children addressed all the nurses as Nurse—Christian names, according to Sister Crump, carried no authority with them, and authority, gentle though it might be, was needed at all times.

Sister Crump had liked Caroline at once; nothing to look at, as she observed to Staff Nurse Neville later, but from all accounts she had acted with commendable promptness on the surgical ward even if she had upset Mr Wilkins’ sense of importance. ‘A fuss about nothing,’ she declared, and sailed into the ward, to clap her hands and tell the children to shout more softly. At the same time she observed that Caroline was sitting on the edge of a small bed, holding a little wriggling girl on her lap while a senior nurse dressed the wound, beautifully stitched, on the small arm.

There were side-wards leading from the main wards where the very ill children lay. It was quiet here, the rooms with glass walls, equipped with all the paraphernalia necessary for urgent treatment and nurses constantly going from one child to the other. In a few days, Staff Nurse had told Caroline, when she had got to know the ward thoroughly, she would take her turn too with the other nurses, looking after one or two children, giving them the specialised treatment they had been ordered. Caroline looked at the array of monitoring screens, tubes and drips and hoped that she would know what to do. Of course, Sister Tutor had explained it all, but applying theory to practice demanded the keeping of one’s wits about one.

She got on well with the other nurses—they were all her senior but she was a little older than most student nurses and made no effort to call attention to herself; besides, she was willing to help out on occasion and made no demands about having days off to suit herself and not the ward. By the end of the week she had been accepted by both nurses and children alike; moreover, Sister Crump had taken care to introduce her to the various housemen who visited the ward, cheerful young men who were quite willing to waste ten minutes playing with the children, eyeing the nurses and coaxing mugs of coffee out of Sister Crump. And when the consultant paediatrician came to do his round she wasn’t exactly introduced, although she was pointed out to him as being the new nurse on the ward. He stared at her, gave her a nod and took no more notice of her; indeed, it would have surprised her very much if he had. He was a youngish man with a long, thin face which lit up when he was with the children. One of the other student nurses, standing discreetly in the background while he went from one small patient to the other, whispered that he had three small children of his own and had married a nurse from the hospital. ‘The children love him,’ she added, ‘and he and old Crumpie get on like a house on fire.’

Certainly the round had none of the formality of a grown-ups’ ward. Mr Spence sat on the cots and small beds, carrying, from time to time, a grizzling infant over a shoulder while he discussed something with his registrar and the housemen. Caroline went home for her next days off happier than she had been for some time, although she had to admit to herself that if only she could banish Mr van Houben from her mind she would be completely happy; he was taking up too much of her thoughts, which was absurd; she had exchanged only a few words with him and none of those exciting enough to engage his attention, and besides, she had made a fool of herself falling down his steps. If he ever thought of her at all, which she doubted, it would be with an amused laugh.

When she went back on duty after her days off it was to be told by Sister Crump that they were short-handed, what with days off and one of the third-year students off sick and a badly injured child brought in late the evening before. ‘Ran away from his nanny, climbed a wall and fell on to a concrete path. Head injuries and in a coma. Mr Spence doesn’t want to operate until he improves; unfortunately he has broken ribs and a punctured lung, makes giving an anaesthetic very tricky. He’s being specialled, Nurse, which means that for long periods you may be alone in the main ward. Can you manage that?’

‘I’ll do my best, Sister. There’s no one very ill there, is there? It’s a question of keeping them happy and potting them and feeding them…’

‘Just so. You’ll have another nurse with you whenever it’s possible and I don’t believe that you’re a girl to panic. Now, we will go through the charts—there are one or two children you must keep an eye on…’

It wasn’t until the afternoon that Caroline was left alone, and it would only be for an hour or so while the other nurse took two children down to the X-ray department. The children had had their after-dinner nap and she had got those who were allowed out of their cots and beds and organised them into manageable groups around the little tables. They were for the most part good; only Bertie, four years old, was a handful. He had been admitted ten days previously, having fallen off a swing in the play-pit below the high-rise flats where his mother lived, twelve storeys high. He hadn’t been found for some time and had been taken, concussed and bruised, to the hospital. Sister Crump had spoken severely to his mother about the risk of letting a very small boy play so far out of her sight and she had promised to go to the social worker and get him taken to a pre-school playgroup. In the meanwhile he was enjoying himself enormously, doing everything he shouldn’t.

He hadn’t settled down with the other children who were up. Caroline, distributing sheets of paper and coloured pencils, saw him making for the ward doors at the other end and darted after him, to catch him into her arms—just as the doors opened and Mr van Houben walked in.

Caroline, clasping a struggling Bertie to her person, stared up at him, her face alight with surprise and delight. Quite forgetful of where she was, and for that matter who she was, she said happily, ‘Oh, hello!’

CHAPTER TWO

CAROLINE saw at once that he wasn’t going to remember her. She hoped that he hadn’t heard her little burst of speech and asked in her most professional voice, ‘Can I help you? Are you looking for someone?’

He looked at her then, but it was impossible to tell if he had recognised her. His handsome face was bland and unsmiling. ‘I’m looking for Mr Spence.’

‘He’s in one of the side-rooms. I think he may be busy. I’m afraid I can’t leave the children to tell him that you want to see him.’

She had wasted her breath for he was striding away down the ward and through the archway to the side-rooms. ‘Oh, my goodness, I shall get eaten alive,’ observed Caroline, a remark which sent Bertie off into a fit of the giggles.

The other nurse had come back presently and they were busy getting the children washed and potted and back into their cots and beds. Caroline was urging the recalcitrant Bertie into his bed when Mr Spence and Mr van Houben came through the ward, walking slowly, deep in talk and followed by Sister and the registrar and two of the housemen. Bertie’s loud, ‘Hey, Doc,’ brought them to a momentary pause, but only long enough to give them time to reply, and that in a rather absent-minded manner. Obviously they had grave matters on their learned minds.

It was Staff Nurse who told her later that the child in the side-room was to be operated on that evening. ‘That’s why Mr van Houben came—he’s a wizard with anaesthetics.’ Caroline, all ears, would have liked to have known more, but Staff was busy and presently she went off duty, to change into outdoor clothes and go with various friends to the local cinema.

The ward was its usual bustling, noisy self when she went on duty in the morning; she helped with the breakfasts and then with the rest of the day staff who could be spared, went to Sister’s office for the report.

It had been a good night in the main ward; duties were meted out in Sister Crump’s fashion, apparently haphazard but adding up to a sensible whole. ‘Little Marc in the side-room—he’ll be specialled of course—usual observations and I’m to be told at once if there’s anything you aren’t too happy about. Nurse Frisby, you will stay with him until you are relieved at noon. Either Staff Nurse or myself will be checking at regular intervals. The operation was successful—a craniotomy and decompression of the vault—but there is some diffuse neuronal damage and the added complication of a punctured lung. The child is gravely ill but we’ll pull him through. There is oedema and some haemorrhaging so be especially on the look out for coning.’ She added briskly, ‘Back to work, Nurses.’

Staff Nurse went with Caroline, who was relieved to see that there wasn’t anything complicated she couldn’t understand. The various scans, machines, tubes and charts she had already worked with on Women’s Surgical. It was a sharp eye and common sense that was needed, said Staff encouragingly. The child was in a deep coma; all Caroline had to do was to check pulse, breathing and temperature at the time stated on the chart, note any change and let her or Sister know at once. ‘Just keep your hand on the panic bell,’ she was advised, ‘and keep your head.’ She looked at her watch. ‘It’s time for observations, so I’ll leave you to get on with it.’ She cast an eye over the small boy in the bed, his head swathed in bandages, his person attached to various tubes. ‘Someone will bring you some coffee,’ she added kindly as she went.

Caroline did everything that was necessary, examined the little white face anxiously and took the chair by the bed. The nurse she had relieved had written ‘No change’ on the chart and with one eye on the child she read the notes on his board. Mr Spence had written a great deal and it took her some time to decipher his writing. Mr van Houben had written a whole lot too. It took her even longer to read, since his writing was so illegible that it could have been in Greek or Sanskrit.

She had just finished her second round of observations when Mr Spence and Mr van Houben came in. They both wished her good morning as she got to her feet and handed over the chart. As she did so, she realised something which she had known subconsciously when she had first studied the chart. Marc’s surname was van Houben. Mr van Houben’s son? If it were so, where was his mother? She had her answer quicker than she had expected.

‘Marc’s mother will be here shortly,’ said Mr van Houben. ‘She will stay only briefly—remain with Marc while she is here. She is likely to be upset.’ He smiled briefly from a grim face and turned to Mr Spence. ‘Would it be a good idea if…?’ He launched into technicalities and Caroline sat down again to keep watch. They thanked her as they went away. It invariably surprised her that the senior men were always civil—with the exception of Mr Wilkins—whereas some of the housemen tended to throw their weight around, wanting this and that and the other thing on the wards, leaving messes to be cleared up.

She was relieved at noon and there was no sign of Marc’s mother. She was sent to first dinner and over the cottage pie and spring cabbage she regaled her friends at the table with her morning’s work.

‘At least it gave your feet a rest,’ said someone.

‘Yes, but I was so afraid something awful might happen—he’s been unconscious ever since he hurt himself and the operation took hours.’

She bolted rhubarb and custard, drank a cup of tea far too hot and went back on the ward. It was time for the children to have their afternoon rest. Sister had gone to lunch, taking all but the nurse specialling Marc with her, leaving Staff and Caroline to the task of seeing to the children who were up and enticing them into their beds and then going around making comfortable those who were bedridden.

‘Marc’s mother came,’ said Staff. ‘Mr van Houben came with her, of course.’

Caroline said, ‘She must be terribly upset.’

‘She was—she’s expecting a baby in a week’s time. She came over from Holland. She’s beautiful—you know—fair hair and blue eyes and the most gorgeous clothes.’

Caroline didn’t want to hear about her—of course she would be beautiful, Mr van Houben wouldn’t have married a girl less than perfection. ‘Is Marc the only one? Other than the baby?’

She lifted out a small sleepy toddler while Staff put in a clean sheet.

‘Yes. Mr Spence seems to think that Marc will live but the thing is if he’s going to come out of this coma. He may have to operate again.’

‘Oh, the poor little boy.’ She kissed the top of the baby’s head; he had a cleft palate and a hare lip but Mr Spence would see to those in a day or two. She put him gently back into his cot and tucked him in.

Staff said, ‘You like kids, don’t you?’

Caroline was at the next cot, changing a nappy. ‘Yes.’

Staff was feeling chatty. ‘Sister says you’re a natural—I dare say you’ll end up with a ward full of children and make it your life’s work.’

‘Yes,’ said Caroline again. She did like children, but she would prefer to have her own; vague thoughts of a charming house in the country with dogs and cats and a donkey and, of course, children filled her mind. She would need a husband, of course. Mr van Houben’s rather frosty features swam before her eyes and she said, ‘Oh, dear, that won’t do at all,’ so that Staff looked at her and observed kindly,

‘Well, there’s always the chance that you’ll marry.’

She was to special little Marc each morning for the foreseeable future. Sister rambled on rather about his subconscious getting used to the same person by his bedside, so that the three of them shared the twenty-four hours between them. It was towards the end of her eight-hour stint that Mr van Houben came again, and this time with Marc’s mother.

Staff hadn’t exaggerated. Marc’s mother was lovely despite the fact that she was desperately worried and pale with anxiety. She stood by the little bed, staring down at the small face, and Mr van Houben put an arm round her shoulders.

Mr Spence came in then and the two men conferred quietly and Caroline said, ‘Sit down for a minute and hold his hand…’

His mother lifted unhappy blue eyes to hers. ‘He does not know?’

‘Well, we don’t know, do we?! I hold it all the time unless I’m doing things for him.’

His mother smiled then. ‘You’re very nice,’ she said, and they sat silently until the men had finished their talk, checked the charts and the three of them had gone away. Caroline sat down again and picked up the limp little paw and held it firmly. It was a way of communication—that was, if communication was possible.

Several days went by and each morning Mr van Houben and Marc’s mother came to see him until one morning Mr van Houben arrived early by himself. His, ‘Good morning, Nurse,’ was curt and he looked as if he had been up all night. If she had known him better she would have told him to go home to bed.

‘Well, Marc has a little sister.’ He stared down at the inert little figure in the bed and Caroline said, ‘Oh, you must be delighted. Congratulations, sir.’

He turned his head to look at her. He looked as though he was going to speak but he only smiled slightly, made sure that Marc’s condition was unchanged and went away. He came back with Mr Spence just as she had handed over to her relief, but since there was no reason for her to remain she went away to eat a late lunch in the empty canteen. The boiled cod and white sauce, boiled potatoes and carrots, edible in company and when freshly cooked, had rather lost their appeal. She ate the apple crumble which followed, coaxed a pot of tea from the impatient girl behind the counter and then went to her room and changed into outdoor things—she was off duty until five o’clock and a brisk walk would do her good. She took a bus to Victoria Park and marched along its paths, in no mood to admire the first of the spring flowers braving the chilly day. She had no idea why she was feeling so edgy; perhaps she was hungry or just a little homesick for Aunt Meg’s cosy little house—or was she just anxious about Marc, who was making no progress at all. Walking back presently to catch her bus back to the hospital, she admitted to herself that it wasn’t any of these things—it was Mr van Houben’s smile when she had congratulated him. It had been faintly mocking, slightly amused, as though she had made a bad joke. Sitting squashed between two stout women with bulging shopping bags, Caroline told herself to stop thinking about him, that there was no point in doing so, and when presently, as she was crossing the forecourt to the hospital entrance, he went past her, on his way to the consultant’s car park, she glared at him so ferociously that he paused and turned to look at her small person; even from the back she looked cross.

When she went back on duty it was to be told that it was intended to operate on Marc again. ‘Seven o’clock, Nurse,’ said Sister Crump. ‘You’ll probably have to stay on duty; Mr Spence wants two of you specialling for the first twelve hours. You’ll stay until a second nurse can come on around midnight. That’ll be Staff or myself.’

She nodded, her cap slightly askew. ‘You and Nurse Foster get Marc ready for Theatre—she’s off duty at six o’clock, and you’ll take him to Theatre. Understood?’ She smiled at Caroline. ‘Run along. We’ll have to fit in your supper somewhere, but at the moment I don’t know when.’

Marc would be wheeled to Theatre on his little bed; they did everything needed, checked the equipment, did their observations, and when Nurse Foster went off duty Caroline sat down to wait, holding Marc’s small hand in hers. She liked Theatre work, although she didn’t know much about it; she had done a short stint during her first year but it hadn’t been enough for her to learn much beyond the care of instruments, the filling of bowls and the conveying of nameless objects in kidney dishes to and from the path lab. She hoped now that she wouldn’t have to go into Theatre; she had grown attached to the silent small boy, away in some remote world of his own, and the thought of Mr Spence standing with scalpel at the ready made her feel a little sick.

Mr van Houben was in the anaesthetic room, somehow managing to look distinguished in his Theatre kit—a loose pale blue smock and trousers topped by a cap which would have done very nicely to have covered a steamed pudding. He was joined by Mr Spence and then by his registrar and all three men held a muttered conversation while Caroline stood patiently by the bed, admiring the back of Mr van Houben’s head, never mind the cap.

It was a disappointment to her that presently one of the staff nurses from Theatre took her place and she was dismissed with a laconic, ‘Thanks, Nurse.’

She went back to the ward and made up the bed and checked the equipment and was then sent to her supper. ‘They’ll send down one of the ITC nurses,’ Sister Crump told her, ‘but you’d better be there to fetch and carry.’

The day staff were going off duty when Caroline went back; the children were sleeping as Sister Crump did a round with the night nurses, and paused to speak to Caroline as she went. ‘I’ll be back presently,’ she told her.

It was after ten o’clock when Marc came back to his little room. Once he was again in his own bed, it was just a question of his being linked up with the apparatus around him and a careful check made as to his condition. Sister Crump had appeared silently to see things for herself and presently Mr Spence and Mr van Houben came in. The little room was full of people, and Caroline, feeling unnecessary, tucked herself away in a corner. Sister Crump caught her eye presently. ‘Go off duty, Nurse,’ she said briskly. ‘Come on at ten o’clock tomorrow.’

Caroline went, feeling anxious about little Marc and rather put out since her off duty had been changed—and she had agreed to go to the pictures on the following evening with Janey and several other of her friends.

She yawned her way into a bath and, despite her concern for the little boy, went to sleep at once.

Marc was still there when she went on duty in the morning; she had been half afraid that he wouldn’t have survived the night but there he lay, looking just as before, with Mr van Houben checking the tangle of tubes around the bed, calculating the drip and then taking a sample of blood from the small hand lying so still on the very white coverlet. He turned to look at Caroline as she went in. ‘Ask Sister Crump to come here, will you, Nurse? You’re taking over here?’