Читать книгу Her Very Special Boss - Anne Fraser - Страница 8

THE sun streaming into her room woke Kirsty. Anxious that she’d overslept, she glanced at her watch and couldn’t believe it wasn’t quite six yet. She stretched, breathing in the unfamiliar but heady scents that drifted in from her open window. Last night, one of the kitchen staff had escorted her to her accommodation after serving her some mashed pumpkin and roast beef. The rest of the staff had all been busy with the aftermath of the accident, so it had been a solitary supper for Kirsty.

Although she had been a little disappointed not to meet and work alongside her new colleagues, part of her had been relieved to get the opportunity of a much-needed early night. She had barely managed to stay awake long enough to shower the blood, sweat and dust away, before collapsing into bed. She had expected to fall asleep the moment her head had hit the pillow, but instead had found herself replaying the events of the day and her introduction to the strangeness of this wild, untamed patch of Africa and its people, including the enigmatic Dr Greg du Toit. Although she couldn’t say her new boss had been unwelcoming, she’d sensed he wasn’t altogether happy to have her there. She had tossed and turned, wondering if she had made the right decision to come to work in this hospital deep in rural Africa. Would she cope? Everything seemed much more basic than she had imagined. But she’d had to get away. Put as much distance between herself and her memories as possible. She wanted—needed—to start afresh make a new life for herself. When at last she had fallen asleep, it had been to dream of Robbie. She had woken up to find tears drying on her cheeks.

But Kirsty was determined that today would be the beginning of her new life. Curious about her new home, she jumped out of bed. There was a set of scrubs on the rickety chair in the corner of the room. They hadn’t been there the night before. Greg must have asked someone to bring them over. She was surprised that he had remembered, with so much going on.

The accommodation certainly wasn’t lavish but, then, Kirsty hadn’t expected it to be. Nevertheless she appreciated the gleaming polished earthen floors smelling faintly of lavender, cool and smooth under her bare feet. And although the furniture was sparse, she knew that with a few touches she could make her new home more appealing.

The house was at least half a century old, with a hodgepodge of additions over time to what must have been the original structure—a circular room from which a tiny scullery, her bedroom and a spartan bathroom led off at various angles, each serving to create interesting nooks and crannies.

The circular room—or rondavel as it was traditionally known—was divided down the middle by a freestanding granite unit that separated the living-room area from the kitchen. On closer inspection Kirsty realised it must have been an autopsy slab from bygone times. However, its antiquated, well-scrubbed appearance amused rather than repulsed her.

While the kettle boiled, she searched fruitlessly for something to eat. In hindsight, she remembered being told that staff meals were served daily in the dining room. If she preferred to prepare meals for herself, she’d have to do her own grocery shopping. Hell, there wasn’t even tea or milk! Dispirited, she flicked the kettle off. Breakfast in the staff dining room it had to be!

She took a quick shower, pleased to find that while the furniture and fittings might be sparse, there was a plentiful supply of steaming hot water. However, she remembered that Africa often suffered severe water shortages and limited her shower to the minimum amount of time needed to soap her body and rinse the last of the dust from her long auburn hair.

She wasn’t expected on duty until the following day but she was eager to see how the victims of yesterday’s accident were faring so she dressed quickly in the scrubs, which were a surprisingly good fit. She wondered if Greg had selected them himself—if he had, he had an accurate idea of her size.

Looking around for a socket for her hairdryer, she was dismayed to find that although there were a few, none fitted her UK plug. Mildly put out, she towel dried it instead, before plaiting it into a thick braid. She would simply have to learn to adapt as best she could to her new environment. After all, she thought with some longing, she was unlikely to find all the conveniences of her home city several hours’ drive into the African bush. Nevertheless, she thought with exasperation, there were some things she couldn’t possibly be expected to do without, and a hairdryer was one of them!

Following the footpath that led from her cottage, she entered the rear of the hospital where most of the wards were situated on different sides of a long passageway. She stepped into the first room on her right through double swing doors and was greeted warmly by a smiling Sister Ngoba, the night sister whom she’d met the previous evening and who was now busy writing up reports before handing over to the day staff. As Kirsty’s eyes roamed the length of the ward, she was surprised to see a familiar head bent over the bed of a female patient whose leg was in traction. When he looked up she could see the stubble darkening his jaw and the fatigue shadowing his eyes.

‘Kirsty?’ he said, sounding surprised. ‘You don’t need to be on duty until tomorrow. Everyone needs a day to settle in.’

‘I know. I wanted to check up on how our patients from the accident yesterday were doing. And I’m longing to get started. I don’t need a day off. Anyway, you’re on duty,’ she challenged.

He smiled tiredly. ‘But I’m meant to be on duty.’

‘You haven’t been up all night, have you?’

‘Almost, but not quite,’ he said, wryly thinking that the hour’s sleep he’d managed to get hadn’t been nearly enough.

‘Thank you for your help yesterday, by the way, and a belated welcome to the team. You’ll meet everyone later.’

‘I look forward to that.’ She paused to smile hello at the patient Greg had been examining. It was the young woman whose tibia and fibula had been badly crushed by the overturned minibus. Lydia, her eyes cloudy with painkillers, managed a weak smile in return, before closing her eyes.

‘How’s our patient?’ Kirsty asked quietly.

‘I think we’ve managed to save her leg. Once I’m sure she’s stable, I’ll arrange to send her to one of the hospitals in the city. They have better equipment than we do, as well as access to physio. For cases like this we patch them up, stabilise them and then send them on.’ He smiled down at the girl and said something to her that Kirsty couldn’t understand.

‘You speak the language?’ Kirsty asked impressed.

‘One or two of them—there are around fifteen different languages or dialects in this country, but I know the ones that are spoken in this neck of the woods. I find it’s pretty useful for communicating with my patients.’ He stretched, working the kinks out of his muscles. ‘But obviously you’ll need a nurse or an assistant to help you translate when there are patients who don’t speak English.’ Kirsty made a mental note to try and master as much of the language as she could. She had learned a few words before coming out, mainly greetings, but intended to learn more.

‘I’m just telling Lydia that the morphine that we’ve given her is what’s making her sleepy. She’ll probably be out for the count for the rest of the day,’ Greg explained, and sure enough Lydia had closed her eyes and seemed to have already succumbed to the sedating effects of the drug. Kirsty and Greg moved away from the bed.

‘I also hoped for a tour of the rest of the hospital. I’m really keen to see it all.’

Greg wrapped his stethoscope around his neck. ‘I could show you later,’ he replied.

‘Please, don’t worry. I’m sure you’ve got enough to do. One of the nursing sisters can—or, if everyone’s busy, I can see myself around. I won’t get in anyone’s way—I promise. But first I need a cup of coffee! I haven’t had any yet and I’m a bit of a caffeine junkie.’

Greg hit his forehead with the heel of his hand. ‘Damn, I’m sorry about that. I meant to organise some provisions for you yesterday but with everything going so crazy here, it completely slipped my mind.’ His sheepish grin was contrite. ‘I’m almost finished the ward rounds so if you can hold on, I’ll show you the dining room. Then unfortunately I’m due in Outpatients so I’ll have to leave you to your own devices.’

‘I’ll come with you to Outpatients, if that’s OK. I’d really like to get stuck in as soon as possible. A coffee and toast will do me until lunch,’ she said.

Greg looked at her appraisingly. Kirsty couldn’t help notice how the corners of his eyes crinkled when he smiled. But even when relaxed there was a presence about the man, an animal-like energy that seemed to fill the room.

‘We could do with the help. Jamie and Sarah are in Theatre this morning and Jenny is anaesthetising for them, so quick rounds, followed by coffee and Outpatients it is.’ He went on, ‘This, as I’m sure you’ve gathered, is the female surgical ward.’ He moved to the next bed. ‘You recognise this young lady?’

It was the woman who had had the femoral bleed, Maria. A quick look at her chart told Kirsty that she was stable.

‘I take it if she’s not in Intensive Care, she’s going to be all right?’

‘We had her in surgery most of the night, but it looks hopeful. Once we’re sure she can tolerate the journey, we’ll send her by ambulance to one of the teaching hospitals in the city. They’ll be able to take it from there.’

‘And Lydia’s little boy? Where is he?’ asked Kirsty, suddenly remembering.

‘He’s in the paediatric ward for the time being. There was nowhere else to put him. He’s been driving the staff crazy with his loud wailing. He won’t be consoled. We’d let him see his mother if she looked a little less frightening. Can’t you hear him?’

And Kirsty did, faintly. She found herself moving in the direction of his cries.

‘Any relatives we can contact?’

‘No one’s come forward to claim him but it’s early still. When the mother surfaces properly, we’ll get more information.’

‘I think he should see her,’ she said firmly.

‘Would that be wise?’

‘He’s, what…about two years old? Old enough for some understanding. I think he needs to feel his mother’s still alive, even though she’s “sleeping”.’

‘It might make things worse. Surely it’s better to wait until she’s alert enough to reassure him herself?’ he suggested.

‘How could anything be worse for him than what it is now? He’s not crying just because he’s miserable and wants to make a loud noise. He’s crying for his mother, and he can’t understand why she’s not coming. In his mind she’s abandoned him.’

‘If you’re sure…’

‘I’m not sure. It depends on his ability to comprehend. But he seemed so well cared-for I’m willing to take a gamble… Besides, I do know a thing or two about children.’ Kirsty felt the familiar crushing pain as she said the words. She ignored Greg’s searching glance and turned towards the cries before he could say anything.

They entered the children’s ward together. The toddler was not the only one crying but he was certainly the loudest. Kirsty’s greeting of the staff on duty was cursory as she focused her attention on the unhappy child. Picking him up, she depended on the natural inherent curiosity of toddlers for him to be distracted long enough for her to talk to him. She was confident that, like most very young children, he understood a lot more than most adults would give him credit for. Recalling the desperate concern of the mother at the accident scene, this child knew love.

‘Shh,’ she said, soothing the distressed infant, dangling her stethoscope in front of him. It took a while but he quietened eventually as, momentarily distracted, he explored his new toy. Kirsty knew that it wouldn’t be long before his cries resumed.

She caught sight of one of his fingers, which had a sticky plaster on it, a superficial pre-crash wound she’d noticed yesterday.

‘Ow,’ she said, lifting his hand and kissing the well-wrapped injury. The little boy seemed hypnotised by her attention. ‘What’s “Mother sleeping”?’ she asked the staff while the boy gazed, astonished, at his finger, as if seeing it for the first time in a new light. ‘Tell him his mummy has a big “ow” and is sleeping.’ The nurse spoke to the child and he listened, taking in what was being said to him.

Armed with a few new words of the language, Kirsty followed Greg back to the surgical ward.

‘Mummy’s sleeping—bomma robetsego,’ she tried in his language as the toddler stared down at his mother. His bottom lip quivered and Kirsty knew tears were not far behind. In an age-long gesture, he leaned out of Kirsty’s arms, his arms stretched pleadingly towards his unconscious mother.

‘Mummy’s sleeping. Shh,’ Kirsty repeated softly, allowing him to touch the still figure. ‘Let her sleep.’

The little boy crumpled in her arms. This time, though, his tears were quieter as she took him away and returned him to the children’s ward.

‘Well, I’ll be damned!’ Greg said, walking alongside her.

‘It doesn’t always work,’ Kirsty admitted, ‘but I thought it worth a try. He’s exhausted so hopefully he’ll sleep now, and when he wakes up someone should take him back to see his mother. With a bit of luck she’ll wake soon and comfort him herself.’

‘And if she doesn’t?’

‘Then he’ll know why,’ she replied simply. ‘If not now, then later when it matters. Children are more able to cope with a parent who can’t help or comfort them. It’s those who think their parents have abandoned them who suffer most.’

Greg flinched and he looked off into the distance, before striding out of the ward, leaving Kirsty to scurry along in his wake. It seemed she had touched a nerve. She was dismayed and not a little curious. What on earth had she said that had affected him like that?

In the male surgical ward, Dr Jenny Carter was taking a blood sample from a patient. She looked up as she heard the ward doors swing open.

Kirsty found her instantly likeable. Plump, with a thick bush of greying hair tied back at the nape of her neck with what looked like a shoelace, she had a gregarious, warm manner.

‘Ah, our new recruit! Come to check we’re taking good care of your patients from last night?’ But there wasn’t an ounce of malice in the question. ‘Here’s Mr Mhlongo. Says we can call him Eddy! And he must be doing fine because he’s already been teasing the nurses. Perhaps we should plaster the other arm, what do you think?’ A nursing sister cheerfully translated the doctor’s words to Eddy.

‘Dumela,’ Kirsty greeted the chuckling man, covered in plaster on one side of his chest all the way down to his fingers with his neck stabilised in a brace. He might not have realised it yet but he owed his life to the seat belt that had prevented him from meeting a similar fate to the driver when the front of the minibus had slammed into the ground. She felt his pulse and although she’d been concerned he might have sustained a serious concussion, his bright eyes told her otherwise. A broken shoulder and a severe case of whiplash seemed to be the worst of his problems. Not so the patient in the bed closest to the nurses’ station or the one in Intensive Care, but the two other patients in the ward she’d attended to yesterday were doing fine.

Kirsty was surprised at the number of patients in the hospital cared for by a very small complement of staff. In fact, some wards were so crowded that some patients were sleeping on mattresses on the floor or, as the case in the children’s ward, doubled up in cots.

‘What about the risk of cross-infection?’ she asked Greg.

‘We are as careful as we can be. Most of those sharing are siblings with the same condition.’

‘Surely not those with HIV or AIDS?’

‘Actually, contrary to popular belief, it is these patients who need to be protected from infection and not the other way around. After all, it is their immune systems that are compromised, rendering them vulnerable to every infection and germ around,’ Greg told Kirsty. He turned to the nursing sister who was accompanying them. ‘Isn’t that right, Sister?’

The nursing sister shrugged her shoulders. ‘Too many with the disease. We try to take special care but…’ The shake of her head told much without words. It had been a fact of life for so long that it was difficult, if not impossible, not to become desensitised.

‘Come on, let’s get you fed and then, if you’re still up for it, you can come and help me in Outpatients. Although it’s Sunday, we’ll have a full clinic. Days of the week have no meaning out here. Most of them will have walked for days just to get here and I don’t like to keep them waiting any longer than necessary. I’ve eaten…’ he glanced at his watch ‘…but I’ve time for a quick cup of coffee, so I’ll show you where the staff dining room is then leave you to it. The other staff will probably be there, except for the Campbells who tend to eat breakfast in their own house.’

When they entered the dining room she was pleased to find Jenny there if no one else.

‘Jenny will show you to Outpatients when you’re ready. Take your time,’ Greg said, and after a quick gulp of coffee left the two women to it.

‘Does he ever slow down?’ Kirsty asked, looking at Greg’s retreating back.

‘Not really,’ Jenny acknowledged. ‘The man is a human dynamo. I can’t remember the last time he took a day off. The rest of us are more human: he insists we take a couple of days at least every third week.’ She eyed Kirsty’s thin frame thoughtfully. ‘Don’t worry, no one will expect you to work these hours, dear.’

‘I’ll do my share,’ Kirsty said. ‘I’m stronger than I look.’ She stirred the lumpy porridge thoughtfully. ‘Maybe Greg works too hard,’ she said, choosing her words carefully. ‘Sometimes he seems a little…well, abrupt. Or is it just me? Have I done something wrong?’

‘Oh, don’t mind Greg. His bark is worse than his bite. He’s a real softy really. As you’ll find out.’

‘Softy’ was the last word Kirsty would have used to describe Greg. ‘What happened to him?’ she asked, curious to know more about this man she was to work with over the coming months.

‘You mean his face? The scars? I hardly notice them any more.’ Jenny hesitated for a moment before seeming to make up her mind. ‘Oh, well, you’ll find out sooner rather than later anyway. It’s impossible to keep secrets in a community of this size. He got them trying to rescue his wife and child from their burning house. They were on their own, just before Christmas—five years last Christmas, in fact. He had been called to the hospital—some emergency I expect. He arrived home to find his house in flames and the fire brigade battling to get it under control. His wife and daughter were still inside. Greg tried to get to them even though the firemen had already failed. They couldn’t hold him back. He went in and brought them out. But it was too late. They had both died from smoke inhalation. Apparently the fire started from the Christmas-tree lights. He was devastated. They were his whole world. I don’t think he has ever come to terms with the loss—I’m not sure that one does.’

Kirsty was stricken. Memories of her own tragedy came flooding back. Although fifteen years had passed, there wasn’t a day when she didn’t think of her mother or Pamela.

Jenny shook her head sorrowfully, unaware of Kirsty’s reaction. ‘I think Greg blames himself, God knows why. There wasn’t anything anybody could have done. The poor man was in hospital himself for weeks. Once he was discharged he left Cape Town. I expect he couldn’t bear to stay anywhere near the place where they had been so happy. He came here and has been here ever since. He works so hard. It’s as if he is trying to exorcise his demons through sheer hard work. He never talks about it or them, and if I were you, I wouldn’t ever raise the topic. I tried once and got my head bitten off.’

‘How awful.’ Kirsty blinked away the tears that threatened to surface. No wonder he was brusque. Now she knew, she would have to be more sympathetic.

‘He still wears his wedding ring,’ she said.

‘You noticed, then?’ Jenny cast a mischievous look at Kirsty. ‘I wouldn’t get any ideas in that direction. There has been many a young doctor and nurse who has tried to offer Greg comfort, but while he doesn’t seem adverse to the odd casual fling, I doubt somehow that he’ll ever let anyone really get under the barrier of ice he seems to have wrapped around his heart.’

Kirsty felt her cheeks flame at the implication. ‘I can assure you,’ she said stiffly, ‘a relationship with anyone is the last thing on my mind.’

Subconsciously she fingered her now bare ring finger. ‘I’ve had enough of men to last me a lifetime.’ She ignored Jenny’s curious look. ‘I’m here to work and to learn. Nothing more.’ She drained her coffee. ‘Sorry.’ Kirsty grimaced, suddenly aghast at the turn the conversation had taken. The kindly doctor in front of her must think her rude. ‘I’m not usually so prickly, it’s just…new place, new people, new challenges. It’ll take me a day or two to settle in, I guess.’

By the time Jenny left Kirsty outside the outpatient clinic, with a hasty apology that she had another Theatre list due to start, there were several patients sitting outside, waiting their turn to be seen. Most of the women still wore traditional dress and despite the intense heat had their children strapped onto their backs with thick blankets. For the most part the children seemed quiet—subdued even. One little boy squatted in the dust, lazily poking at the ground with a stick. When he looked up Kirsty could see that one of his eyes was sticky with what looked like a chronic infection. She tilted his chin—he needed something for his eyes, the sooner the better. She glanced around and spotted a nurse moving between the patients, taking histories and writing notes. Kirsty guessed she was probably assessing who needed to be seen first. Just before Kirsty could grab her attention she noticed a young woman clutching a bundle to her breast. There was something in the woman’s posture—an air of despair—that made Kirsty catch her breath. She moved closer, and gently lowered the blanket to reveal a small, painfully thin child who was making no effort to take the proffered breast of the young mother. The child’s face was so thin it seemed almost skeletal, the skin clinging to the fragile bones of the skull. Flies settled and buzzed around the tiny mouth and closed eyes. For a heart-stopping moment Kirsty thought the child was already dead. She felt for a pulse and was rewarded with a faint flutter beneath her fingertips. The child was still alive, but surely not for long. With one swift movement she lifted the infant up, its tiny frame feeling no heavier than a feather, and rushed into the department. This child couldn’t wait. It needed fluids in the form of a drip straight away or he or she would die.

Ignoring the wails of the young mother, she searched frantically for Greg. She found him crouching in front of an old woman, examining a suppurating sore on her foot.

Greg took one look at Kirsty’s anguished expression and stood up.

‘What is it?’ he asked, bending forward to look at her small bundle. ‘Not another case of marasmus—starvation,’ he said despairingly. ‘OK, bring her into the treatment room and let’s see what we can do. If there is anything we can do.’

Within moments the small child, a girl, was lying on the couch, her mother sitting close by, her eyes flitting from Kirsty to Greg. One of the nurses had joined them and was talking to the mother in rapid Sotho.

‘The child stopped taking the breast two days ago. She’s been sick for over a week. A traditional healer gave her mother some herbs to give her, but when they didn’t help and she stopped taking the breast, the mother decided to bring her to us. It’s taken two days for her to get here.’

While the nurse repeated the history, Greg and Kirsty had been searching for a vein in which to insert a drip. Kirsty knew that they had to get the small child rehydrated as soon as possible.

‘I can’t find any in her arms. They all seem to have collapsed,’ Kirsty told Greg, fear catching her voice. They had no time. The child could die if they didn’t treat her right away.

Greg looked up at her. ‘Slow down. We’ll find one. Look here just above the foot. We’ll need to do a cut down. It’s not ideal, but it’s all we have. Have you done one before?’

‘I have, but I’d rather watch you first, if that’s OK,’ Kirsty said. This child was so small, so desperately ill. What if she was too slow?

‘You’ll have to do it, I’m afraid. You may have noticed my right hand only has restricted movement. It’s fine except for the most delicate stuff.’ Kirsty could only guess what it cost Greg to admit his limitations. At the same time she admired him for it. She had once seen a doctor attempt to perform procedures above his capabilities and the results had almost been disastrous.

Greg noticed Kirsty’s hesitation. ‘You’ll be fine. I’ll talk you through it.’

Somehow his belief in her gave her confidence and with very little assistance from Greg she performed the procedure perfectly and without any wasted time.

‘Excellent job.’ Greg’s praise was fulsome and genuine and Kirsty felt elated. She thought that she might grow to like her job here.

‘OK, let’s get her started on the usual regime.’ He directed a few rapid words towards the mother.

‘She’s three years old,’ he translated for Kirsty.

Once again Kirsty was horrified. Three! It wasn’t possible. The child looked no older than nine months, a year at the most. She was so tiny.

‘Obviously we can’t use her age to work out how much we need to give her. By my guess she weighs just over eight kilograms. Could you pop her on the scales?’ he asked the nurse.

The nurse scooped the child up and laid her gently on the scales.

‘Just right—eight kilos,’ she told Greg.

‘Any thoughts on the dosage we should be administering?’ Greg asked Kirsty.

Kirsty thought frantically. She had completed six months in paediatrics as part of her houseman jobs. But the children there had been so much bigger, stronger than this child in front of her. She had never seen anyone in such an advanced stage of starvation before. How could she have? But she remembered a child, physically handicapped, who had been brought in following a severe episode of diarrhoea. The child’s condition had been similar to if not quite as drastic as that of this child in front of her.

She was about to hazard a guess, but Greg hadn’t waited for her response. He adjusted the drip and straightened up. She could sense the fatigue and something else—could it be anger?—behind his professional exterior.

‘We’ve done everything we can for the time being. It’s in the lap of the gods now.’ He tossed his gloves into the bin. ‘The main problem is caused by formula. The government spends substantial sums of money promoting breast-feeding, but the problem is with the women who are HIV positive. The danger of them transmitting the disease to their infants through breast milk is just too large, so they are encouraged to give their babies formula. Unfortunately formula is too expensive for most of them, so they start diluting it to make it go further. Then the children simply don’t get enough calories or nutrition. And as if that isn’t bad enough, a large number of the outlying villages still don’t have access to clean water. So the women mix the powder with water from the river. And what you see before you is the result.’

‘Can’t we do anything about it?’ Kirsty asked. ‘Surely it’s just a matter of education?’

Greg smiled, but there was no humour in his eyes. ‘Education and clean water. That’s what is needed. In the meantime…’ He let the words hang in the air for a moment. ‘In the meantime we do the best we can. Come on, Kirsty, as you’re about to see, there is plenty more for us to do.’

‘But doing the best we can isn’t enough. Is it? Not if children are still dying?’ Surely he wasn’t going to tell her there was nothing they could do to prevent this? He didn’t strike Kirsty as a man who let anything stop him from doing what was right.

‘We’ll talk about it later,’ Greg said quietly but firmly. ‘Right now we have work to do. You take the consulting room next door. I’m just across the hall. If you need me, give me a shout, but try the nurses first. I think you’ll find that there is precious little they can’t help you with.’ And without waiting for a reply, he turned on his heel and left the room.