Pestilence (2 page)

“All too soon,” replied Saracen.

As Saracen climbed into the back of Medic Alpha he paused to look over at the houses that bordered the ring road. Most of the people who had earlier been at their windows to see the excitement had returned to their television sets. Real life drama had begun to pall. Saracen had picked up some road grit in his mouth; he spat it out on the tarmac.

The rain had still not relented by the time Medic Alpha arrived back at Skelmore General and one of the ambulance men stepped in a puddle up to his ankles as he wheeled the trolley up to the doors. Saracen accompanied the trolley with the intention of handing over his patient to the surgical registrar on duty and then going home. He could hardly believe the sight that met his eyes. A&E resembled the Beggars’ Court of eighteenth century Paris.

“What’s going on?” he asked Tremaine, the houseman who had called him.

“Three things,” answered the flustered houseman. “It’s Saturday night, the weather is bringing in the drop-outs and City were playing United at home. There was trouble.”

Saracen looked around him and swore under his breath. The treatment room was full, the waiting room was full. Half a dozen policemen were talking to people and writing things in note-books. The sound of gagging and retching came from one of the side rooms. Saracen looked in and found Sister Lindeman cajoling a teenage girl into swallowing a gastric aspiration tube.

“OD?” Saracen asked.

“A hundred aspirin. Her boyfriend left her.”

In a corner of the main treatment room Saracen caught sight of a nurse sitting down. It was such an unusual thing that he knew something must be wrong. He went over and saw that the girl was holding the side of her face.

“What happened?”

“One of the drunks,” replied the girl.

Saracen lifted her hand away to assess the damage and saw the early signs of bruising. “Did you tell the police?” he asked.

“Jack Lane dealt with him,” replied the girl.

“Do your teeth feel all right?” asked Saracen.

The nurse smiled and said, “I’m all right, really I am. Just give me a moment.”

Saracen squeezed her shoulder and continued on a quick inspection tour. He looked in on the waiting room but the smell that met him made him wish that he had not. It was a mixture of vomit, urine and wet clothing. All the chairs were full and people were squatting on the floor. A woman was wandering up and down with tears flowing down her face and Saracen recognised her, she was regular in A&E when it rained. She was known to the Unit as Mary.

Mary was one of the people that the Sunday Supplements liked to call the ‘twilight people’ in their intermittent features on life’s unfortunates between advertisements for Porsche cars and Swedish furniture. She was alone in the world and had the IQ of a child although now in her early thirties. She had spent her entire adult life either sleeping rough or in a succession of hostels and assessment centres having fallen through one of the many gaps in the Welfare State. She could not be admitted to a regular hospital because there was nothing physically wrong with her and she could not be admitted to a mental establishment because, although retarded, she was not mentally ill. This left her alone in a world with very little sympathy for a thirty year old bed-wetter with the mind of a ten year old child.

On the occasions when being turned out of a hostel coincided with bad weather Mary would turn up in A&E in floods of tears and stinking of urine in the hope of a bed and a little kindness. She was rarely successful for the simple truth was that Mary was not alone. There were a lot of ‘Marys’ on the streets, out of sight and out of mind.

“Come on now Mary, you know the rules,” said Saracen gently.

“But Doctor I’m ill,” whined the woman.

A porter came up to Saracen and whispered in his ear, “We’ve been on the blower and the church hostel in Freer Street will take her for tonight.”

Saracen nodded, grateful that he was not going to have to turn Mary out on the street. “C’mon Mary,” he said, “We’ve found a nice warm bed for you.”

The sobbing subsided and Mary came towards Saracen with open arms. Saracen steeled himself for the embrace and held his breath. He patted her back and hoped that she would release him before the stench of ammonia overpowered him. “I’m sure one of these nice policemen will run you round to the hostel while they’re waiting.”

The nearest constable raised his eyes to the ceiling before saying, “Of course,” with less than marked enthusiasm. He whispered to Saracen as the porter led Mary out, “It took us three days to fumigate the Panda last time.”

Saracen returned to find Tremaine and said to him, “You’ll need some help, I’ll stay.”

“I wasn’t going to ask…honest.” said Tremaine.

Saracen smiled and put on his white coat.

Sister Lindeman had finished pumping out the stomach of the teenager. She left her in the care of another nurse while she returned to the main treatment room to see how things were going. She saw Saracen and grinned. “Couldn’t stay away huh?”

“That’s about it Sister. Who’s next?”

Saracen started working his way through the aftermath of a violent Saturday. Tiredness prevented any kind of small talk and limited him to asking only relevant questions before working in silence. He accepted the answers with no sign of emotion for exhaustion had brought on a detachment that shielded him from the boring, mindless monotony of the reasons given for the injuries he was treating. Bottle… beer glass… steel comb… bread knife.

Saracen was working on his fourth patient when reception alerted them to the arrival of an ambulance carrying victims of another road accident. A few minutes later a trolley was wheeled quickly into A&E with an entourage of police and ambulance men. A distraught woman with blood running down her face from a cut on her forehead ran alongside the trolley, unwilling to let go. Saracen guessed correctly that it was her husband lying on it.

“It was the rain…it was the rain…David has always been such a careful driver but it was the rain. The car just spun, there was nothing he could do…it was the rain…”

In the background Saracen saw one of the ambulance men shake his head. He said to one of the nurses, “Nurse, would you find a seat for Mrs?…”

“Lorrimer,” replied the woman. “With two ‘r’s,” she added nervously.

Saracen smiled reassuringly at her as she was led away to the waiting room then he turned to her husband.

“I think he’s had it,” said the ambulance man who had shaken his head. He filled Saracen in on the details of the accident while Saracen examined the man. Saracen stood up from the table and said, “You’re right. He’s dead, ‘ribs probably punctured his heart. The PM will say for sure.”

“Will you tell his wife?” asked one of the policemen.

Saracen said that he would and went to find the woman. She had been taken to one of the side rooms by a nurse. She got up as Saracen entered and smiled nervously before starting to speak quickly as if in the belief that she could make something true by saying it often enough.

“He is all right isn’t he? Just a bit of a bump. I thought so. This weather really is the limit. I was just saying to David before the accident…” Her voice trailed off as Saracen took both her hands in his. “I’m sorry,” he said, “Your husband is dead Mrs Lorrimer. There was nothing we could do.”

The woman’s eyes widened then filled with tears as the bottom fell out of her world. She began to sob uncontrollably and Saracen held against his shoulder, raising his hand to stop the nurse who made to move forward and take her away. He let the woman cry herself out before lifting her gently off his shoulder and asking if there was anyone they could contact to be with her. A relative? A friend? “Nurse will clean you up and get you some tea,” he said, ushering her into the waiting arms of the nurse. Saracen returned to the main treatment room as a heavily built man lurched in from the waiting room.

“I wanna see a doctor,” he demanded, his voice slurred with drink. He transferred his weight unsteadily from one foot to the other as he tried to focus on the scene in front of him.

“You’ll have to wait your turn,” said Saracen. “Go back to the waiting room please.”

“I wanna see a fuckin’ doctor now!” demanded the drunk. He brought his fist down on the edge of an instrument tray sending a shower of steel up into the air. He staggered back as if amazed at the consequence of his action.

“You’ll have to wait your turn like everyone else. Go back to the waiting room,” said Saracen.

“Who fuckin’ says so?”

“I fuckin’ do,” said Saracen evenly.

The drunk sniggered. “Are you gonna make me like?” he whispered hoarsely.

“No, he is,” said Saracen matter of factly. He nodded to the porter, Jack Lane who had just returned from taking a patient to X-Ray. He looked down at the drunk from six and a half feet and said quietly, “This way my son…there’s a clever boy.” He led the drunk out by the scruff of the neck.

Tremaine shrugged and said to Saracen, “Twenty minutes ago this place was full of policemen. Now, when you want one…”

Saracen stitched up another cut head then walked over to the sink to wash his hands. He levered on the taps with his elbows and took in the sights around him as he washed. The clock up on the wall said twenty past two and exhaustion was inducing a cynical numbness. How different it all was from his pre-medical school view of medicine when family and friends had encouraged him in the notion that he was about to become one of God’s chosen people, or at least, society’s. He smiled faintly as he recalled the image he had nurtured through his student years, the one where he, dressed in a neat grey suit, was standing on the steps of a bright, modern hospital waving good-bye to a grateful family who looked as if they had stepped out of the pages of Homes and Gardens. “How can we ever repay you Doctor?” they were saying.

“Oh, it’s nothing really…”

Saracen saw the symbolism in washing his hands as he looked at the last of a Saturday night’s clientele at Skelmore General. “Barabbas it is then,” he said softly, but not so softly that a passing nurse did not hear. “Did you say something Doctor Saracen?” she asked.

“No. nothing.”

The stream of patients dwindled to a trickle and the last one finally limped out through the swing doors at twenty minutes past three. Saracen sat down slowly on one of the tubular frame chairs and tilted it back to rest his head against the wall. Alan Tremaine joined him and read aloud from the clip board in his hand. “Forty three patients, fourteen admitted to the wards, four palmed off on to the County Hospital, one dead on arrival, the rest discharged.”

“Tea?” asked Sister Lindeman.

“Please”

Tremaine put down the clip board and stretched before putting his hands behind his head. “Only two more months of A&E to go,” he sighed. “How long have you been doing it James?”

“Six years.”

Tremaine expelled breath loudly and said, “You know, I can’t begin to tell you how grateful I am to you for helping out tonight.”

“Forget it,” said Saracen.

“Something should be done about Garten,” said Tremaine, “How does he keep getting away with it? I’ve got a damned good mind to complain to the authorities about him.”

“You will do no such thing,” said Saracen with an air of finality that took Tremaine aback, “You will keep your mouth shut, finish your residency and leave with a good reference. Understood?”

“If you say so…But it’s so unjust.”

“Don’t waste your time looking for justice. Keep your nose clean and get on with your career.” With that, Saracen got up and left through the swing doors.

Sister Lindeman returned with the tea and looked surprised. She looked around her and then asked, “Has Doctor Saracen gone?”

Tremaine replied that he had. He accepted the mug that Sister Lindeman held out and asked almost absent mindedly, “How come James is still only a registrar? He must be what, thirty five? thirty six? Come to that, why is he still working in A&E?”

“I’m sure I don’t know what you mean Doctor,” said Sister Lindeman. Her voice was cold enough to ensure that Tremaine knew not to pursue that line of conversation.

Tremaine sipped his tea, still deep in thought. “And as for Garten…”

“Drink your tea Doctor.”

Saracen pulled up his collar against the wind and walked up the hill to find the duty porter. The man emerged from his turreted gate-house when he saw Saracen approach.

“Where did you leave my car?” Saracen asked.

“It’s round the back, parked behind the bins.” The man dropped the keys into Saracen’s hand and said good-night. Saracen turned and walked back down the hill, taking care not to slip on the wet cobblestones. It had stopped raining but only recently for water still trickled down the hill through the joints and crevices of a surface that had been laid before the turn of the century.

Unlike the front of the building which had an array of neon signs and direction indicators the lighting was poor at the back for the rear boasted no public buildings save for a small chapel attached to the mortuary. The lighting was therefore minimal and comprised solely of electric conversions to the original gas mantle holders on the walls.