Trauma (14 page)

Stanley curled his lip and replied, 'Frankly Father I find the idea of a celibate man giving a talk on marriage vaguely ridiculous. It's intellectually offensive.'

'I see,' said Lafferty calmly, when he really wanted to grab Stanley by the collar and ask him, 'Then why don't you just sod off and stop wasting my time?'

'Stanley! Don't be so rude,' cautioned Anne in a loud whisper. She put a restraining hand on Stanley's knee. 'Stanley likes to question everything Father,' she said to Lafferty. 'He's very bright you see.'

Lafferty nodded and smiled. Why did nice girls always go for turds like Stanley? he wondered. 'Well, it's always a privilege to meet up with an inquiring mind Stanley,' he said.

The interview proceeded with Stanley restricting himself to the occasional snort or curl of the lip while Anne made up for her fiancée’s rudeness with excessive attentiveness and politeness. Lafferty who had felt his knuckles bunch several times throughout the ordeal, was relieved when it was over and he could show the couple the door. He noticed that Stanley was a good couple of inches shorter than Anne as he walked along behind them. He himself, at six foot one, towered over both. As they left, he heard Stanley say to Anne, 'Medieval darling, positively medieval.' Lafferty raised his eyes heavenward and whispered quietly, 'Lord, just a small accident?'

* * * * *

Sarah was delighted to find that, as the day wore on, Logan was actively keeping out of her way. She had stood up to the school bully and he had backed down just like he should according to all the best stories. Bright children usually found out that this was actually rubbish and the passport to hospital but it was nice to see practice agree with theory for once. She was enjoying her day in the unit more than any she could remember and it was reflected in her demeanour. The slightly worried, withdrawn look that the nurses had come to expect of her as she waited in trepidation for Logan's next onslaught was now replaced with a confident smile. I may be young and relatively inexperienced but I am basically a good doctor, she had decided. 'And nobody is going to take that away from me. Not Logan, not Tyndall, not anyone.

Sarah completed brain function tests on the six patients she had been assigned and plotted their progress or lack of it on their daily update charts. Four remained on a plateau, one had actually shown some loss of function but the last, a patient named Trevor Brown in Beta 2, was showing a definite improvement in terms of electro-pulse readings. Brown had been in a coma for the past thirteen weeks but Tyndall had predicted that he would recover. Many consultants were reluctant to make such predictions about coma patients but the state of the art equipment that HTU was blessed with enabled them to detect the slightest of changes in brain function and base prognoses on them. In particular, the Sigma Scan apparatus which Murdoch Tyndall had played a major role in developing was proving itself in the field trials it was undergoing.

Unlike the other monitoring probes which only needed the attachment of exterior electrodes, Sigma Scan required that two electrodes be surgically implanted inside the patient's skull. The procedure was not suitable for all patients but in those who had had them implanted it had been possible to achieve an incredibly sensitive estimation of brain activity. Tyndall had worked out a table for the readings and from that a formula that could be applied to predict a patient's recovery potential.

Sarah applied the formula to the figures for Brown and came up with the prediction that he would surface from the coma at some time during the next thirty-six hours.

Sarah was taking her work sheets back to the duty room when she passed through Alpha and noticed that John McKirrop's admission sheet was still hanging on the end of his bed. She was puzzled. She thought that Logan would have wanted to carry out the tests on McKirrop himself - especially as Tyndall had asked to be kept informed. She looked for Logan and found him examining an electro-encephalogram with the aid of a magnifying lens and a ruler. She coughed to attract his attention.

'Yes, what is it?' said Logan without turning round.

'About Mr McKirrop's tests . . .'

'You do them. The tramp's all yours.'

'But Dr Tyndall asked to be . . .'

Logan turned round and grinned but there was more malevolence than humour in it. 'He was being polite,' said Logan. 'You're the blue-eyed girl of the moment. You do them and tell him what you find. As far as I'm concerned, McKirrop’s a waste of time. He's going to die. With a bit of luck we'll get permission to use his organs for transplant and he'll be a bloody sight more use dead than he's ever been alive.'

Sarah bit her tongue believing that Logan was deliberately trying to goad her into speaking out of turn. She ignored his callousness and simply said, 'Very well, Doctor.' It was important not to lose the ground she had gained with regard to Logan. She had resolved to be cold and curt in her dealings with him. She returned to the duty room and asked Sister Roche if she could have a nurse to help her with the tests on McKirrop.

'Of course,' said Roche. 'I'll give you Nurse Barnes. She's on the console at the moment. She could do with a change.

The 'console' was a computerised monitoring station that sat outside the entrance to Beta with Alpha on one side and Gamma on the other so that the duty nurse could see into all three from the swivel chair she sat in. In front of her, a bank of VDUs gave her a read out of the vital signs of all twelve patients. A bank of red warning lights sat along the base of the unit ready to flash along with an audible warning buzzer should any patient falter in their tenuous grasp on life. Sister Roche relieved Nurse Barnes herself at the console.

Having established that McKirrop's blood pressure was acceptable and his pulse rate steady, Sarah set about adorning his head with a series of electrodes. First she and the nurse had to make sure that as good an electrical contact as possible was achieved. This they did by depilating and cleaning the relevant areas of the skull and rubbing on high conductivity jelly before taping the electrodes into position. McKirrop's injuries to the front of his skull had ruled out the surgical implantation of Sigma probes.

'This always reminds me of these awful experiments we had to do in biology at school,' said Nurse Barnes. 'You know, the ones with the frogs.'

'Don't remind me,' said Sarah, screwing up her face. 'What a bunch of sadists we all were. How are we doing?'

'All ready I think,' replied the nurse.

Sarah made some last fine adjustments to the oscilloscope controls, getting the wave form as clear as possible on the screen. 'Will you check the recorder settings?' she asked the nurse.

Nurse Barnes moved away from the patient to stand by the roll-chart recorder. 'Shoot,' she said.

Sarah read out the settings on the oscilloscope. 'X-axis, 5.'

'Check.'

'Y-axis, 5.'

'Check.'

'Amp 4'

The nurse moved a knob one click to the right before saying, 'Check.'

'Gain, 10.'

'Check.'

'Let's go for it.'

Nurse Barnes pressed the green START button on the recorder and the chart pen started to make its trace over a set time course. The nib made a scratching sound as it rose and fell on the rolling chart, leaving a thin red record of where it had been. A buzzer sounded and the pen fell to the base line. Sarah removed the completed chart and set up the next test. It took forty five minutes in all to gather the information she needed for McKirrop's first condition appraisal. On completion, she thanked Nurse Barnes and took her file of graphs and read-outs to the doctor's room to begin a detailed analysis.

The 'doctors' room' sounded much grander than it actually was. It was in reality one of the original ward side-rooms which had not been modernised at the time of the creation of HTU. It was close to the front door leading to the main corridor and lifts and was sparsely furnished with a table, three chairs in varying states of decay and a coffee percolator which Sarah switched on as soon as she went in.

There was a calendar sponsored by a local garage up on the back of the door and various charts supplied by pharmaceutical companies pinned up on the walls here and there to break the monotony of vast areas of pale green paint. The only thing the room had going for it was that it was quiet apart from the gurgle of water when it rained - there was a drain pipe situated immediately outside the window. At the moment it was fair. There was an unwritten rule in the unit that no one would disturb you there unless it was really necessary. For that reason the room had been dubbed, the ivory tower.'

Sarah lost track of time as she analysed McKirrop's tests. The conclusion she was coming to was not what she expected so she was forced to double check everything. The fact that Tyndall had asked to be personally informed of the results had put an added burden on her. She mustn't make a fool of herself over this. She remembered the mug of coffee that had been going cold at her elbow and took a sip. 'Well, John McKirrop,' she said quietly. 'Unless I'm very much mistaken you're not nearly as badly injured as everyone thought you were. The question is . . . why not?'

Sarah stared thoughtfully at the papers in front of her on the table for a few more moments before deciding to take another look at the patient. She met Sister Roche in the corridor as she was going off duty.

'I didn't realise you were still here,' she said. 'Shouldn't you be off duty too?'

'I won’t be long,' smiled Sarah. 'I need a break: I'm on call tonight.'

'Have a quiet one,' said the nurse.

'I wish,' said Sarah.

Sarah nodded to the night Staff Nurse who had taken up station at the console and walked through to Alpha 4. She took her pencil torch from her top pocket and opened McKirrop's eyelids, first right and then left, with her left thumb to shine the light in them. 'Well I'm blowed,' she murmured, putting the torch away again. She stood at the foot of the bed for a moment, watching McKirrop's face as if looking for clues but the tubes and electrodes had stolen any sense of personality.

The tramp, as Logan had dubbed him, had obviously been a good looking man in his youth. He might still have been had he not been living rough with wind, weather and alcohol taking their toll. He still had high cheek bones but his cheeks had hollowed below them and his eyes had sunk back into deep dark sockets. But the fact that the nursing staff had cleaned him up and the wound in his forehead was hidden by pristine white bandaging had given him some semblance of quiet dignity.

'I wonder . . .' she muttered as an idea occurred. She went to the X-ray room and searched for McKirrop's skull pictures. She found the one that had come up from A&E with the patient - the one she’d shown Tyndall that morning - but she had a vague recollection of seeing another envelope arriving from the X-ray department an hour or so later.

After a brief search she found the delivery envelope. Now she remembered. She had seen the porter bring them in but had assumed that Logan was going to be doing McKirrop's tests so she had put them out of her mind. It looked as if Logan hadn't bothered to look at them.

Sarah pinned them up on the light box and adjusted her spectacles on her nose. One of the X-rays did not add anything to what she knew but the other confirmed exactly what she had begun to suspect. The slightly unusual angle of McKirrop's forehead had decreed that the frontal lobe of his brain was further back than normal in most patients. The injury that had appeared so horrific at first glance, although still very bad in terms of associated shock and trauma, would not have caused nearly as much brain damage as they had been assuming. This was why the tests she had run had given such optimistic readings.

With a bit of luck, John McKirrop might actually survive his latest adventure and still be able to do the seven times table. In fact, there was a possibility that he might even recover consciousness before morning. This put Sarah in a quandary. Should she wait with the patient until he did come round and thereby witness the proof of her theory or should she call Tyndall right away with her diagnosis and prediction? She decided on the latter despite realising how furious Logan was going to be. If he had bothered to look at the X-rays himself, he would have seen what she had worked out and been in line for the brownie points instead of her.

Sarah called Tyndall from the duty room after laying out the relevant charts in front of her on Sister Roche's desk in anticipation of any question Tyndall might ask. She also had the X-ray beside her on a chair. She felt her mouth become a little dry as she waited for Tyndall to answer.

'Professor Tyndall please,' said Sarah when a woman answered.

There was a short pause before Tyndall came on the line.

'It's Dr Lasseter here sir, said Sarah. 'You asked to be kept informed about Mr McKirrop's condition.'

'So I did,' said Tyndall pleasantly. 'He died I suppose?'

'No sir, far from it. I think he might pull through and quite possibly without any significant brain damage.'

'We are talking about the same patient Doctor?' asked Tyndall. 'The down and out from the canal?'