The Citadel (2 page)

With an effort Andrew put the puzzle from his mind. He was young, strong, and had no objection to the extra work in which Page’s illness might involve him. Indeed, in his enthusiasm, he yearned for an avalanche of calls.

‘You’re lucky, doctor,’ remarked Miss Page brightly as she came into the dining-room. ‘You can have your bit of snap straight off to-night. No surgery. Dai Jenkins done it.’

‘Dai Jenkins?’

‘He’s our dispenser,’ Miss Page threw out casually. ‘A handy little feller. And willin’ too. “Doc” Jenkins some folks even call him, though of course he’s not to be compared in the same breath with Doctor Page. He’s done the surgery and visits also, these last ten days.’

Andrew stared at her in fresh concern. All that he had been told, all the warnings he had received regarding the questionable ways of practice in these remote Welsh valleys flashed into his recollection. Again it cost him an effort to be silent.

Miss Page sat at the head of the table with her back to the fire. When she had wedged herself comfortably into her chair with a cushion she sighed in pleasant anticipation and tinkled the little cow-bell in front of her. A middle-aged servant with a pale, well-scrubbed face brought in the supper, stealing a glance at Andrew as she entered.

‘Come along, Annie,’ cried Miss Page, buttering a wedge of soft bread and placing it in her mouth. ‘This is Doctor Manson.’

Annie did not answer. She served Andrew in a contained, silent fashion with a slice of cold boiled brisket. Miss Page had a cut from the same joint with, in addition, a pint of fresh milk. As she poured out the innocuous beverage and lifted it to her lips, her eyes upon him, she explained:

‘I didn’t have much lunch, doctor. Besides, I have to watch my diet. It’s the blood. I have to take a drop of milk for my blood.’

Andrew chewed the uninteresting brisket and drank cold water determinedly. Following a momentary dissatisfaction, his main difficulty lay with his own sense of humour. After all, he could not expect to find luxury upon the tables of these spartan valleys.

During the meal Miss Page ate in silence. At length, buttering her last crust of bread, she finished her meat, wiped her lips after the last of the milk and sat back in her chair, her thin figure relaxed, her eyes reserved, appraising. Now she seemed disposed to linger at table, inclined to confidences, perhaps trying in her own way to sum Manson up.

Studying him, she saw a spare and gawky youngster, dark, rather tensely drawn, with high cheekbones, a fine jaw and blue eyes. These eyes, when he raised them, were, despite the nervous tensity of his brow, extraordinarily steady and inquiring. Although Blodwen Page knew nothing of it, she was looking at a Celtic type. Though she admitted the vigour and alert intelligence in Andrew’s face, what pleased her most of all was his acceptance, without demur, of that cut from the three days’ old heel of brisket. She reflected that, though he looked hungry, he might not be hard to feed.

‘I’m sure we’ll get on famous, you and me,’ she again declared with quite a genial air. ‘We do need a bit of luck for a change.’ Mellowed, she told him of her troubles and sketched a vague outline of the practice and its position. ‘It’s been awful, my dear. You don’t know. What with Doctor Page’s illness, wicked bad assistants, nothin’ comin’ in and everythin’ goin’ out – well! you wouldn’t believe it! And the job I’ve had to keep the manager and mine officials sweet – it’s them the practice money comes through – what there is of it,’ she added with a shrug. ‘You see, the way they work things in Drineffy is like this – the Company has three doctors on its list, though, mind you, Doctor Page is far and away the cleverest doctor of the lot. And besides – the time he’s been here! Nearly thirty years and more, that’s something I should think! Well, then, these doctors can have as many assistants as they like – Doctor Page has you, and Doctor Nicholls has a would-be fellow called Denny – but the assistants don’t ever get on the Company’s list. Anyway, as I was saying, the Company deducts so much from every man’s wages they employ at the mines and the quarries and pays that out to the listed doctors according to how many of the men signs on with them.’

She broke off, gazing at him quizzically.

‘I think I see how the system works, Miss Page.’

‘Well, then!’ She gave out her short laugh. ‘You don’t have to bother about it any more. All you’ve got to remember is that you’re working for Doctor Page. That’s the main thing, doctor. Just remember you’re workin’ for Doctor Page and you and I will get on a treat.’

It seemed to Manson, silent and observant, that she felt she had unbent too far. With a glance at the clock, she straightened herself, restored her napkin to its horn ring. Then she rose. Her voice was different, businesslike.

‘By the way, there’s a call for Number Seven Glydar Place. It came in the back of five o’clock. You better do it straight away.’

Andrew went out to the call immediately, with a queer sensation, almost of relief. He was glad of the opportunity to disentangle himself from the curious and conflicting emotions stirred up by his arrival at Bryngower. Already he had a glimmer of a suspicion as to how matters stood and of how he would be called upon by Blodwen Page to run the practice for his disabled principal. It was a strange situation, and very different from any romantic picture which his fancy might have painted. Yet, after all, his work was the important thing, beside it all else was trivial. He longed to begin it. Insensibly he hastened his pace, taut with anticipation, exulting in the realisation – this, this was his first case.

It was still raining when he crossed the smeary blackness of the waste land and struck along Chapel Street in the direction vaguely indicated by Miss Page. Darkly, as he traversed it, the town took shape before him. Shops and chapels – Zion, Capel, Hebron, Bethel, Bethesda, he passed a round dozen of them – then a big Co-operative stores, and a branch of the Western Counties Bank, all lining the main thoroughfare, lying deep in the bed of the valley. The sense of being buried, far down in this cleft of the mountains, was singularly oppressive. There were few people about. At right angles, reaching up a short distance on either side of Chapel Street, were rows and rows of blue roofed workers’ houses. And, beyond, at the head of the gorge, beneath a glow that spread like a great fan into the opaque sky, the Drineffy hematite mine and ore works.

He reached 7 Glydar Place, knocked breathlessly upon the door, and was at once admitted to the kitchen where, in the recessed bed, the patient lay. She was a young woman, wife of a steel puddler named Williams, and as he approached the bedside with a fast beating heart he felt, overwhelmingly, the significance of this, the real starting-point of his life. How often had he envisaged it as, in a crowd of students, he had watched a demonstration in Professor Lamplough’s wards. Now there was no sustaining crowd, no easy exposition. He was alone, confronted by a case which he must diagnose and treat unaided. All at once, with a quick pang, he was conscious of his nervousness, his inexperience, his complete unpreparedness, for such a task.

While the husband stood by in the cramped, ill-lit stone floored room he examined the patient with scrupulous care. There was no doubt about it, she was ill. She complained that her head ached intolerably. Temperature, pulse, tongue, they all spoke of trouble, serious trouble. What was it? Andrew asked himself that question with a strained intensity as he went over her again. His first case. Oh, he knew that he was over-anxious! But suppose he made an error, a frightful blunder? And worse – suppose he found himself unable to make a diagnosis? He had missed nothing. Nothing. Yet he still found himself struggling towards some solution of the problem, striving to group the symptoms under the heading of some recognised disease. At last, aware that he could protract his investigation no longer, he straightened himself slowly, folding his stethoscope, fumbling for words.

‘Did she have a chill?’ he asked, his eyes upon the floor.

‘Yes, indeed,’ Williams answered eagerly. He had looked scared during the prolonged examination. ‘Three, four days ago. I made sure it was a chill, doctor.’

Andrew nodded, attempting painfully to generate a confidence he did not feel. He muttered, ‘We’ll soon have her right. Come to the surgery in half an hour. I’ll give you a bottle of medicine.’

He took his leave of them and with his head down, thinking desperately, he trudged back to the surgery, a ramshackle wooden erection standing at the entrance to Page’s drive. Inside, he lit the gas and began to pace backwards and forwards beside the blue and green bottles on the dusty shelves, racking his brains, groping in the darkness. There was nothing symptomatic. It must, yes, it must be a chill. But, in his heart he knew that it was not a chill. He groaned in exasperation, dismayed and angry at his own inadequacy. He was forced, unwillingly, to temporise. Professor Lamplough, when confronted by obscurity in his wards, had a neat little ticket, which he tactfully applied: PUO – pyrexia of unknown origin – it was noncommittal and exact, and it had such an admirable scientific sound!

Unhappily, Andrew took a six ounce bottle from the recess beneath the dispensary counter and began with a frown of concentration to compound an anti-pyretic mixture. Spirits of nitre, salicylate of sodium – where the dickens was the soda sal. Oh, there it was! He tried to cheer himself by reflecting that they were all splendid, all excellent drugs, bound to get the temperature down, certain to do good. Professor Lamplough had often declared there was no drug so generally valuable as salicylate of sodium.

He had just finished his compounding and with a mild sense of achievement was writing the label when the surgery bell went ‘ping’, the outer door swung open, and a short, powerfully thick-set red-faced man of thirty strolled in, followed by a dog. There was a silence while the black and tan mongrel squatted on its muddy haunches and the man, who wore an old velveteen suit, pit stockings and hobnail boots with a sodden oilskin cape over his shoulders, looked Andrew up and down. His voice, when it came, was politely ironic and annoyingly well-bred.

‘I saw a light in your window as I was passing. Thought I’d look in to welcome you. I’m Denny, assistant to the esteemed Doctor Nicholls, LSA. That, in case you haven’t met it, is the Licentiate of the Society of Apothecaries, the highest qualification known to God and man.’

Andrew stared back doubtfully. Philip Denny lit a cigarette from a crumpled paper packet, threw the match on the floor, and strolled forward insolently. He picked up the bottle of medicine, read the address, the directions, uncorked it, sniffed it, recorked it and put it down, his morose red face turning blandly complimentary.

‘Splendid! You’ve begun the good work already! One tablespoonful every three hours. God Almighty! It’s reassuring to meet the dear old mumbo-jummery. But, doctor, why not three times a day? Don’t you realise, doctor, that in strict orthodoxy the tablespoonfuls should pass down the oesophagus three times a day.’ He paused, becoming, with his assumed air of confidence, more blandly offensive than ever. ‘Now tell me, doctor, what’s in it? Spirit of nitre by the smell. Wonderful stuff, sweet spirit of nitre. Wonderful, wonderful, my dear doctor! Carminative, stimulant, diuretic, and you can swill it by the tubful. Don’t you remember what it says in the little red book? When in doubt give spirit of nitre, or is it pot. lod. Tut! Tut! I seem to have forgotten some of my essentials.’

Again there was a silence in the wooden shed broken only by the drumming of the rain upon the tin roof. Suddenly Denny laughed, a mocking appreciation of the blank expression on Andrew’s face. He said derisively:

‘Science apart, doctor, you might satisfy my curiosity. Why have you come here?’

By this time Andrew’s temper was rising rapidly. He answered grimly.

‘My idea was to turn Drineffy into a health resort – a sort of spa, you know.’

Again Denny laughed. His laugh was an insult, which made Andrew long to hit him. ‘Witty, witty, my dear doctor. The true Scots steamroller humour. Unfortunately I can’t recommend the water here as being ideally suited for a spa. As to the medical gentlemen – my dear doctor, in this valley they’re the rag-tag and bobtail of a glorious, a truly noble profession.’

‘Including yourself?’

‘Precisely!’ Denny nodded. He was silent a moment, contemplating Andrew from beneath his sandy eyebrows. Then he dropped his mocking irony, his ugly features turned morose again. His tone, though bitter, was serious. ‘ Look here, Manson! I realise you’re just passing through on your way to Harley Street, but in the meantime there are one or two things about this place you ought to know. You won’t find it conform to the best traditions of romantic practice. There’s no hospital, no ambulance, no X-rays, no anything. If you want to operate you use the kitchen table. You wash up afterwards at the scullery bosh. The sanitation won’t bear looking at. In a dry summer the kids die like flies with infantile cholera. Page, your boss, was a damn good old doctor, but he’s finished now, finished by overwork, and’ll never do a hand’s turn again. Nicholls, my owner, is a tight little money-chasing midwife. Bramwell, the Lung Buster, knows nothing but a few sentimental recitations and the Songs of Solomon. As for myself, I better anticipate the gay tidings – I drink like a fish. Oh! and Jenkins, your tame druggist, does a thriving trade, on the side, in little lead pills for female ills. I think that’s about all. Come, Hawkins, we’ll go.’ He called the mongrel and moved heavily towards the door. There he paused, his eyes ranging again from the bottle on the counter to Manson. His tone was flat, quite uninterested. ‘ By the way, I should look out for enteric in Glydar Place if I were you. Some of these cases aren’t exactly typical.’

‘Ping’ went the door again. Before Andrew could answer Doctor Philip Denny and Hawkins disappeared into the wet darkness.

It was not his lumpy flock mattress which caused Andrew to sleep badly that night, but the growing anxiety of the case in Glydar Place. Was it enteric? Denny’s parting remark had started a fresh train of doubt and misgiving in his already uncertain mind. Dreading that he had overlooked some vital symptom he restrained himself with difficulty from rising and revisiting the case at an unearthly hour of the morning. Indeed, as he tossed and turned through the long restless night he came to ask himself if he knew anything of medicine at all.