Doctor On The Job (10 page)

Outside Mr Clapper’s door was waiting a small, thin, brown man in a towelling hospital dressing-gown. He immediately grasped the dean by his lapels and said desperately, ‘Sir Lionel Lychfield… I know you. I’ve seen you in the ward. Help me, I beseech you. I must get out of here at once.’

The dean staggered back, alarmed. ‘Don’t tell me the patients are on strike, too?’

‘I am not his patient. I am his brother-in-law.’

‘I don’t think I entirely follow,’ said the dean confusedly.

‘Professor Ding’s. From Shanka. He is going to take my heart out and put in some total stranger’s.’

‘Oh, yes, I remember now. He’s here on an exchange professorship arranged by the Ministry of Overseas Development. An extremely worthy idea for breaking down tensions in Brixton and such places. He’s only doing it for your own good,’ the dean comforted the patient, trying to disentangle his fingers.

‘He is doing it for a fat pension from the crook who runs our country,’ the man said bitterly. ‘My heart is absolutely tip-top. I have bad feet, but my brother-in-law isn’t interested in operating on feet, which have little glamour.’

‘If you have any complaint whatever about your treatment,’ the dean told him, freeing himself, ‘you need have no fear that it will go unheard. As long as it’s well-grounded, efficient action will most certainly be taken on your behalf.’

‘Ah! Good!’ The man’s face suffused with joy. ‘I knew you were a good fellow. Wisdom and benevolence flash from your eyes as sunlight from precious jewels.’

‘Thank you.’

‘My relief is indeed heartfelt. How do I go about making use of this most welcome information?’

‘You are in a National Health Service Hospital, so you can enjoy all the benefits of our National Health Service administration. Exactly as if you had the advantage to be born a British subject,’ the dean explained. ‘A personage has been created exactly for your purposes. His title is the “Health Commissioner”, though the public always refer to him as the “Ombudsman”.’

“Ombudsman”,’ repeated the patient slowly. ‘Please, Sir Lionel, when can I find this powerful individual in the hospital?’

‘Oh, he isn’t in the hospital.’ The dean gave an amused glance. ‘I don’t know where he is, exactly. I suppose you could try Whitehall. But his location is immaterial, because of course all complaints must be made in writing. Mr Clapper in this office will certainly know the correct procedure.’ He indicated the door behind him. ‘You should certainly get a reply one way or another within six months to a year.

‘But in six months I shall be dead and buried,’ the man said, aghast. ‘With somebody else’s heart inside me, too.’

‘Well, that’s your problem, I suppose. Will you excuse me? I’ve an urgent meeting in the basement.’

The patient grasped the dean’s lapels again. ‘But, Sir Lionel – don’t you understand? Wherever this functionary exists, I must have him release me from the hospital immediately.’

‘There is nothing whatever to stop you discharging yourself whenever you feel inclined,’ the dean told him testily, trying to dislodge the fingers again. ‘This is St Swithin’s, not Wormwood Scrubs.’

‘Ah, there you is, my old china – !’ A voice came booming down the corridor. ‘You sure got me worried.’

The huge jovial figure of Professor Ding approached rapidly. His patient grasped the dean more firmly, making whimpering noises.

‘For just a minute you had me thinking that you was getting scared and doing the bunk before your life-saving operation. Sir Lionel Lychfield, I presume?’ He laughed loudly, shaking the dean’s hand powerfully while clasping his diminutive patient firmly round the shoulders. ‘This one, he mighty nervous. I keep telling him, “Don’t you quake so, sonny, this operation past the experimental stage, just routine, like having your tonsils out.”’

‘Most certainly great strides have been made in the technique of transplant surgery,’ the dean nodded agreement.

‘Nothing to it. We just waiting for some stupid bugger crash his car, come into hospital with the old heart still going pit-a-pat, but no breathing, no brain, no nothing, we plug him on to the old respirator, and we say, “Okay, count down to blast off”, then we sharpen up the old knife and we dig in.’ He squeezed the patient fondly, making him gurgle. ‘Simple as eating your Sunday dinner.’

‘You are in very good hands,’ the dean explained patiently to the little man, still pulling at his fingers. ‘I understood from the Ministry of Overseas Development that Professor Ding has an enormous reputation in your own country.’

‘As a witch doctor,’ said the patient.

Professor Ding patted him several times on the back, making his jaw wobble. ‘This ignorant sod don’t know which doctor is which doctor,’ he said. ‘Joke, hey?’ He laughed, but not as loud as usual. ‘Cummon, sonny boy. You and me gonna play lots more nice games of Scrabble, hey?’ He gave his patient a jerk, ripping him from the dean’s lapels. ‘We play Scrabble till that unknown benefactor of humanity goes and wipes his four litre sports job along a brick wall, hey?’

The dean hurried away in the direction of the stairs, reflecting on the tenderness of African surgical professors, who so considerately calmed their patients’ preoperative nerves by playing cards with them. He could hardly imagine Sir Lancelot making up a four at bridge with a gastrectomy, a cholecystectomy and some piles.

The St Swithin’s concourse downstairs looked much as usual. Nobody seemed to be taking much notice of a single porter in his brown coat standing with a placard saying BACK ACHE. Through the front door, the dean could see a television camera with its crew, and the kilted Forfar McBridie marching up and down for them playing the bagpipes.

The dean turned towards the steps leading into the basement. He saw his first difficulty as prizing Faith away from the side of Pip. Possibly he would have to utter some white lie, like her mother having broken a leg. But this was spared him by Faith herself hurrying upstairs. ‘Daddy,’ she said at once. ‘I want to have a very serious word with you.’

The dean invited her into the staff canteen behind the lifts for a cup of coffee.

‘Daddy,’ said Faith, sipping from her white plastic beaker as they took a table in one corner. ‘You have been very, very naughty.’

‘Me?’ returned her father indignantly. ‘When I have been humiliated before our entire complement of student nurses by my own daughter, who openly connives with this pint-sized Lenin to inflict starvation upon my patients –’

She laid a finger softly on his lips. ‘Daddy, you are suffering from hubris.’

‘You make it sound like a particularly unpleasant disease, and I am not suffering from anything of the kind.’

‘Yes, you are,’ she said quietly. ‘You and all the doctors at St Swithin’s. The sorrow is that you don’t know you’ve got it. And as you always say, Daddy, it’s the patient who makes his disease fatal, by overlooking it. I worry about you, honestly I do.’ She looked at him wide-eyed. ‘You forget that the hospital care of sick people is a team effort –’

‘Of course I don’t. I tell the students exactly that every year in my inaugural lecture. Some of the old hands know it well, and utter groans at that juncture.’

‘But a team effort of the humblest as well as the highest,’ she persisted softly. ‘A hospital can’t work without consultants. But it can’t work without porters or laundry workers or cleaners, either.’

‘Exactly. The difference is, my dear,’ he told her tartly, ‘that my importance is apparent when I start work. Theirs only when they stop.’

Faith considered this. ‘I don’t think that alters the principle. Anyway, Pip doesn’t see it that way. He wants you to arrange for representatives of these workers to have a seat on the council which runs St Swithin’s. Then he’ll call off the strike.’

‘Outrageous! Am I to argue about such matters as the provision of a new electroencephalograph, or even of a place to park my car, with one of the hospital
porters
?’ he asked contemptuously.

‘Pip says that’s what happens in Russia,’ she told him calmly. ‘All the health service workers have been in the same union for years. Including the doctors. And everyone knows that Russian medicine is among the best in the world.’

‘I don’t care if Russian doctors operate to the sound of balalaikas and have snow on their rubber boots. Here we’ve still got the shreds of democracy. Which means that I give the orders and the porters carry them out.’ The dean folded his arms decisively.

Faith sighed. ‘Well, Daddy, those are Pip’s conditions for calling off the strike. Until they’re met, I’m afraid you won’t be able to use the Bertie Bunn for making more shekels from sheikhs. But that’s the wrong currency, isn’t it?’

‘If Pip Chipps takes my advice, he’ll hop on the next train home to Somerset. These porters will soon tumble to it, that he’s simply leading them a dance to satisfy his own abnormal sense of humour. I shouldn’t like to be in his shoes then. Pretty tough-looking eggs, some of the porters. Criminal records, too, I shouldn’t doubt.’

‘Please don’t delude yourself, Daddy. We’ve no blacklegs and no scabs.’

‘When I started medicine, a blackleg was an advanced form of gas gangrene, and a scab was something you got from chicken-pox. Now they mean anyone who values human life above union solidarity.’

‘I know you feel frustrated over the trade unions, like many of your class,’ she told him patiently. ‘But you must accept modern life as it is.’

‘Yes. With everyone doing exactly what they like, not giving a thought to the convenience or comfort of their fellow-beings. And the worst offenders of all are governments.’

Faith stood up. ‘I must rush now. I’ve got a meeting of the strike committee. If you want to surrender, you’ve only to phone down to the porters’ room.’

The dean banged the pink formica top of the table. ‘We shall never surrender,’ he declared stoutly. ‘We shall fight at the bedsides, we shall fight on the landings, we shall fight in the filing departments and in the stores, we shall fight in the halls. We shall defend our hospital, whatever the cost may be. And furthermore, you stupid little girl,’ he ended, losing his temper, ‘all your lecherous lunatic’s former student friends will give exactly that answer when I appeal to their common sense to chuck him out neck and crop.’

She left her father scowling into the dregs of his coffee. His diplomatic offensive seemed to have crumbled under her counter-attack. He would charge upon a more vulnerable flank.

‘Look out, here comes trouble.’ Tony Havens quickly emptied his pint of beer, set the mug down on the counter of the residents’ bar and stood with his back to it. ‘It’s the dean,’ he explained, nodding towards the door.

Hugo Raffles followed his companion’s action promptly. ‘He must have come to shut the place down,’ he suggested gloomily.

‘I can’t think of any other reason. I’ve never seen the old buzzard in here all my days at St Swithin’s.’

‘Perhaps he’s come to buy drinks all round?’

‘You’re more likely to get a fart out of a corpse.’

A hush fell upon the score or so young men and women gathered in the bar just before lunchtime that same day. Darts players became immobilized statues, billiards players froze at their cues, the fruit machine clicked into silence. ‘He’s smiling,’ whispered Hugo urgently.

‘At us,’ agreed Tony, eyebrows raised.

‘Perhaps he’s drunk?’

‘Or the strike’s unhinged his mind. He seems to have taken it rather seriously. He’s been going about all morning as though he was on the operating list for extramural cephalectomy.’ He made a gesture across his throat.

‘We’d better talk earnestly about medicine,’ said Hugo, as the dean approached their corner.

Tony Havens nodded. ‘It is very important to distinguish between Kleinfelter’s syndrome and Turner’s syndrome,’ he observed loudly. ‘Kleinfelter’s has forty-seven chromosomes with an XXY constitution, but Turner’s has of course forty-five chromosomes with an XO constitution. Good morning, sir,’ he broke off in surprise, as the dean appeared in front of his nose. ‘This is an unexpected pleasure.’

‘Ah… Havens… Raffles…care for a…er, jar?’

‘That’s extremely kind of you, sir.’ Tony hid an intense curiosity over what was up. ‘Neither of us is working this afternoon, and we are of course very conscious of your disapproval towards housemen who take the smallest sip while on call. I’m attending a refresher course – that’s work, naturally, sir,’ he added hastily, ‘but only sort of sitting down-work.’

The dean smiled more widely. ‘I’m sure you hard-pressed residents need to enjoy a relaxing drink once you have a few minutes’ opportunity. Barman, two half-pints, please,’ he ordered. ‘I’ll have a small sherry. I hear the Cyprus sort is excellent value for money. Chipps was a particular pal of you two, I believe?’

‘We mucked in together a good deal as students,’ Tony agreed.

‘Mucked in,’ repeated the dean, nodding thoughtfully. ‘Well, I don’t know who put up the idea to him of becoming a porter. Possibly it was some practical joke.’ The pair looked innocent. The dean continued smiling. ‘Naturally, I can take a joke. Eh? Havens? Raffles?’

‘Renowned for it in the hospital, sir,’ Hugo told him.

‘Bung…er, ho.’ The dean sipped his sherry. ‘But it would seem that the joke has gone wrong. Or Chipps has gone wrong. The strain of the sudden social descent has afflicted him with paranoia. He was always most unstable mentally, as I’m sure you’ll agree?’ They nodded heartily. ‘So his persecution mania drives him to organizing this ridiculous strike against his old friends and colleagues. The only result is getting our dear old hospital a bad name, pictures of half-naked actresses in the Press, that sort of thing.’

‘The patients started pulling our legs as soon as they got their morning papers,’ Tony told him.

‘Not only the hospital but we consultants individually are losing our patients’ good money – I mean good will. Obviously, this neurotic Napoleon downstairs would never listen to me. But you’re his old friends. For the sake of St Swithin’s, can’t you persuade him to call it off?’

The pair exchanged glances. ‘Pip’s a pretty determined sort of chap, sir.’

‘You mean, you don’t want to appear as – er, dean’s narks?’

‘I think we’d just prefer to keep clear of someone else’s row, sir.’

‘But supposing I was able – Good God, have you finished a whole half pint already? Supposing I was able to make it worth your while?’ The dean’s smile developed an oily surface. ‘Your jobs at St Swithin’s end with the present month, remember. Doubtless you will be seeking posts more senior?’

‘Not in St Swithin’s, sir,’ Hugo told him. ‘It’s this strike which finally made up our minds, as it happens. Private practice in Britain could be for the chop. We’re emigrating.’

‘So much the better.’ The dean rubbed his hands slowly together. ‘This very morning’s post brought an inquiry for some rising young surgeon and anaesthetist to make a career at a privately run medical centre in Las Vegas, a town I understand to be a lively little place. The emoluments are so enormous that for a moment I considered working at both posts myself. There is also provided a ranch-type house, or house-type ranch, I forget which.’

‘Car?’ asked Hugo.

‘Unfortunately no. Only the helicopter. I would just add that the appointment is entirely in my hands.’

The three fell silent. Tony and Hugo slowly put down their glasses. The dean remained smiling and rubbing his hands. ‘I think you will find your friend in the basement,’ he suggested. ‘He seems to prefer commanding operations from underground, as Herr Hitler in his final stages.’

A few minutes later, Tony and Hugo were pushing open the door of the smoky porters’ room. Several dozen men in unbuttoned brown coats were as usual lounging about the benches. One or two were listening without much interest to Pip, who was orating standing among copies of the morning’s papers, Faith taking down his words in a large notebook. He broke off at once, striding to the door bright-eyed, brown coat flapping.

‘An enormous success, isn’t it?’ he greeted his two friends. ‘Meet the strike committee – Harold there, my left-hand man, and Faith my right-hand one. Without her,’ he explained, slipping an arm tenderly round her shoulders, ‘I should never have found this new determination to stand up to the people who’ve been pushing me about for years.’

‘The strike is one hundred per cent solid,’ said Harold Sapworth. ‘At this moment of time, there’s no possibility of a sell out, none whatever. The lads regret the inconvenience to the public, but someone’s got to get hurt. We’re ready at any time to meet with anyone who’s going to talk sense.’

‘Oh, Harold, do try to stop talking like a trade union leader on television,’ Faith told him wearily.

‘Power!’ Pip slapped fist into palm. ‘I have rediscovered the most powerful weapon of the century – organized workers. We are more powerful than any Army,’ he declaimed, arms wide apart, turning to the rest of the room. ‘An Army can only shoot us, thus getting a terribly bad Press all round the world. Moreover, Brothers, willing workers follow their leaders more blindly than any troops the most inspiring of military commanders.’ The audience on the benches went on reading and playing cards, giving Tony and Hugo the impression of having heard it all before. ‘Modern civilization has played into our hands by its very complexity. Even the means of securing such basic necessities of life as light and heat, food and water, have become unbelievably intricate since the days of candles and logs, cabbage-patches and wells. A few strategically placed workers can bring any community to its knees in a matter of days, even hours.’

Pip stopped, chin tipped towards the ceiling.

‘Pip, don’t you think you should have a word with Dr Bonaccord?’ suggested Hugo seriously. ‘It’s his afternoon for behaviour therapy.’

‘On the contrary, I have discovered my normal self. All my life I’ve been inhibited, frustrated, unaggressive. Faith has been my psychiatrist.’ He embraced her again. ‘She rubbed my lamp and the genie came out.’

‘How vulgar,’ murmured Hugo.

‘And this gift for oratory. I never knew I possessed it. It’s quite frightening how I can sway my audiences. I suppose Trotsky would have found the same, if he’d started addressing a nurses’ prizegiving.’

‘It’s wonderful how Pip’s become famous overnight from Land’s End to John o’ Groats,’ said Faith admiringly.

‘He could have achieved that by chucking a bomb at the Queen,’ remarked Tony.

‘Do I detect a certain hostility?’ asked Pip, sounding hurt.

‘You do. We think this strike is bloody cruel. It’s against sick people.’

Pip looked aghast. ‘There’s nothing in the slightest cruel about us. Is there, Faith? We’re only striking against the consultant capitalists. If sick people happen to be involved, it means that our industrial action must be settled all the sooner. A blitzkrieg does far less damage and kills far fewer people than something like the Somme.’

‘Look, Pip –’ Tony had reeled back, hand to forehead. ‘Come up to the bar and have a drink.’

‘A porter?’ Pip grinned, flapping his brown coat with both hands. ‘I won’t embarrass you.’

‘You became a porter for a joke. Right? To get your own back on the dean. Right? Well, the joke’s over.’

‘The dean threw me out.’

‘The dean’s thrown hundreds of students out. But they didn’t take their revenge by wrecking the work and reputation of the hospital.’

‘With which we are getting just the teeniest, weeniest bit fed up, dear boy,’ Hugo told him.

Pip stuck both fists deep into his brown coat pockets. ‘I hadn’t thought of it like that,’ he admitted solemnly. ‘Am I really damaging the hospital’s reputation?’ They both nodded forcefully. ‘I shouldn’t care for that. After all, I’m part of St Swithin’s, as much as ever.’

‘That’s more the way to talk,’ said Tony warmly. ‘And I’m sure you don’t really want to antagonize old pals like us, who’ve helped you over the years. We’d even have got you through your finals, if only you’d poked the other eye.’

‘That’s true,’ Pip agreed. ‘You two had rather dropped out of my mind, with all the excitement.’

‘So why not say, “It’s been a big giggle, a great gas, but enough’s enough”?’

‘Who put you two up to this?’ Faith asked crisply, snapping shut her notebook. ‘My father, I suppose?’

She stared at Tony so knowingly, he could only reply evasively, ‘We agreed to do it in Pip’s own interest.’

‘You didn’t. My father mentioned to me over coffee this morning something about appealing to your better nature. Knowing my father and his students better than he thinks,’ she continued evenly, ‘I realized that he really meant he was going to bribe you. How much?’

‘Is this true?’ demanded Pip.

‘Of course he didn’t bribe us,’ Tony replied indignantly. ‘He merely agreed to help both of us to practise in Las Vegas.’

‘Where everyone develops tennis-elbow from shaking hands with one-armed bandits,’ Hugo added.

‘You
were
bribed,’ said Pip severely.

‘Not really,’ Hugo told him languidly. ‘We’re emigrating anyway.’

‘You’re not,’ said Pip. ‘You’ve just given me an absolutely brilliant idea. That’ll be the next plank in my platform. It’s barefaced robbery, newly qualified doctors walking off with an education obtained at the expense of the British taxpayer. I bet even ladies in Tory hats would agree with that. After all, it’s mostly their taxes. Once we stop medical emigration, all our problems will be over. We can reduce doctors’ salaries, finish private practice and at last have the National Health Service adequately financed and fully manned. The doctors will lose their single weapon in the fight. So simple.’

‘How are you going to stop us going?’ Tony asked defiantly.

‘Easy. They manage it in Russia. As we’re an island, there’s no need for minefields. Medically qualified Channel swimmers I think would be a negligible problem.’

‘You
are
mad,’ he asserted. ‘That’s just not on. This isn’t the Soviet Union. It isn’t even Yugoslavia. It’s Britain. And you can’t interfere with the liberty of the individual.’

‘Oh, individual liberty,’ Pip said impatiently. ‘That’s got a cash value, like everything else. What sort of individual freedom can the workers of Britain afford? Not much. Think of all the places the capitalists can walk into without a second thought – hotels, restaurants, the Royal Enclosure at Ascot, the pavilion at Lord’s, first-class carriages on the trains. I’m amazed the railwaymen’s union haven’t put a stop to that one. The workers are permanently barred from these places, because they haven’t the money in their pockets, that’s all.’

‘We only ask for a fair and just settlement,’ put in Harold Sapworth, who seemed not to be following the conversation.

Pip slapped fist into palm again. ‘Faith, take a letter to the Secretary of State for Social Services, Alexander Fleming House, Elephant and Castle, SE1. Harold can take it across on the bus. I suppose everyone leaves there promptly at five o’clock, the Minister included. Dear Minister…’ Faith flipped open her notebook. ‘Say that in the name of ACHE, no British doctors must be allowed to leave the country from one minute after midnight. If our demand is not met instantly, we shan’t call off the strike.’

‘“…the strike in the Bertram Bunn Wing”,’ Faith supplied, writing in her book.

‘No, the strike paralysing St Swithin’s Hospital itself, from apex to boiler-house, from antenatal clinic to post-mortem room.’

‘But we’re not on strike in St Swithin’s.’

‘We are now.’ He leapt on a bench. ‘Brothers! Forward with the browncoats! Everybody out.’