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CHAPTER 4 Post-operative

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Thursday, the eleventh. Late afternoon.

Sir John waited in the theatre for his patient.

The matron, Jane and Nurse Banks came in with Thoms. They stood near the table, a group of robed and expressionless automata. They were silent. The sound of wheels. A trolley appeared with Dr Roberts and the special nurse walking behind it. Dr Roberts held the anæsthetic mask over the patient’s face. On the trolley lay the figure of the Home Secretary. As they lifted it on the table the head spoke suddenly and inconsequently.

‘Not today, not today, not today, damn’ the bloody thing,’ it said very rapidly.

The special nurse went away.

The reek of ether rose up like incense round the table. Dr Roberts wheeled forward his anæsthetising apparatus, an object that, with its cylinders of compressed gases carried in an iron framework, resembled a gigantic cruet. A low screen was fixed across the patient’s chest to shut off the anæsthetist. Thoms looked at the patient curiously.

‘He’s a striking-looking chap, isn’t he?’ he remarked lightly. ‘Curious head. What do you make of it, Roberts? You’re a bit of a dog at that sort of thing, aren’t you? Read your book the other day. There’s insanity somewhere in the racial make-up here, isn’t there? Wasn’t his old man bats?’

Roberts looked scandalized.

‘That is so,’ he said stiffly, ‘but one would hardly expect to find evidence of racial insanity clearly defined in the facial structure, Mr Thoms.’

The sister arranged the sterile coverings over the abdomen. With the head screened, the patient was no longer an individual. A subject for operation lay on the table—that was all.

Sir John took up a scalpel and made the first incision.

‘Peritonitis, all right,’ said Thoms presently.

‘Hal-lo!’ he added a little later. ‘Ruptured abscess. He’s made a job of it.’

‘Accounts for the attacks of pain,’ Phillips grunted.

‘Of course, sir. Wonder he kept going so long—look there.’

‘Nasty mess,’ said Phillips. ‘Good God, Matron, are you deaf? I said forceps.’

Sister Marigold bridled slightly and gave a genteel cough. There was silence for some time. Sir John’s fingers worked, nervously, inquisitively, and with a kind of delicate assurance.

‘The pulse is weak, Sir John,’ said Roberts suddenly.

‘Oh? Look at this, Thoms.’

‘I don’t like this pulse.’

‘What’s the matter, Roberts? Pulse?’

‘Yes. It’s rather weak. I don’t like his looks. Get me an injection of camphor, will you, Nurse?’

Nurse Banks filled the second small hypodermic syringe and brought it to him.

‘Give it, Nurse, at once, please.’

She did so.

‘Serum,’ grunted Phillips.

‘Serum, Nurse Harden,’ murmured the sister.

Jane crossed to the table of apparatus. There was a little delay.

‘Well—well, where is it?’ asked Phillips impatiently.

‘Nurse!’ called Thoms angrily. ‘What are you doing?’

‘I’m sorry—but—’

‘It’s the large syringe,’ said Nurse Banks.

‘Very well,’ said Jane faintly.

She bent over the table.

Phillips finished sewing up the incision.

‘Nurse,’ repeated Thoms, ‘will you bring me that syringe? What’s the matter with you?’

An agitated drop appeared on the end of his nose. Sister Marigold cast an expert glance at it and wiped it off with a piece of gauze.

Jane came back uncertainly, holding the tray. Phillips straightened his back and stood looking at the wound. Thoms put on the dressing and then gave the injection.

‘Well,’ he said, ‘that’s that. Very nasty case. I suppose he’s neglected it.’

‘I believe so,’ answered Phillips slowly, ‘I saw him the other evening and I had no idea he was ill—no idea of it.’

‘How’s the condition now, Roberts?’ asked Thoms.

‘Not too brilliant.’

‘Well—take him to bed,’ said Phillips.

‘And take that tray away,’ added Thoms irritably to Jane who still stood at his elbow.

She turned her head and looked into Phillips’s eyes. He seemed to avoid her gaze and moved away. She turned towards the other table. Her steps grew more uncertain. She stopped, swayed a little, and fell forward on the tiled floor.

‘Good God, what’s the girl up to now?’ shouted Thoms.

Phillips strode across the theatre and stood staring down at her.

‘Fainted,’ he said behind his mask. He looked at his bloodstained gloves, pulled them off and knelt beside her. Sister Marigold ‘Tut-tut-tutted’ like a scandalized hen and rang a bell. Nurse Banks glanced across and then stolidly helped Thoms to cover the patient and lift him back on the trolley. Dr Roberts did not even look up. He had bent over the patient in an attitude of the most intense concentration. Two nurses came in.

‘Nurse Harden’s fainted,’ said the matron briefly.

They managed to get Jane to her feet. She opened her eyes and looked vaguely at them. Between them they half carried her out of the theatre.

The patient was wheeled away.

Phillips walked off into the anteroom followed by Thoms.

‘Well, sir,’ remarked Thoms cheerfully, ‘I think the usual state of things has been reversed. You are the fierce member of the party as a rule, but today you’re a perfect sucking-dove and I damned that poor girl to heaps. I’m sorry about it. Suppose she was feeling groggy all through the op.’

‘I suppose so,’ said Phillips, turning on a tap.

‘I’m sorry about it. She’s a nice girl and a good nurse. Attractive. Wonder if she’s engaged.’

‘No.’

‘Not?’

‘No.’

Thoms paused, towel in hand, and stared curiously at his senior. Sir John washed up sedately and methodically.

‘Unpleasant game, operating on your friends, isn’t it?’ ventured Thoms, after a pause. ‘And such a distinguished friend, too. Jove, there are lots of Bolshie-minded gentlemen that wouldn’t be overwhelmed with grief if O’Callaghan faded out! I can see it’s hit you up a bit, sir. I’ve never before seen the faintest tremor in your hands.’

‘My dear Thoms, there’s nothing the matter with my hands.’

‘Oh—I’m sorry.’

‘Nothing to be sorry about.’ He took off his gown and cap and brushed his hair. ‘You’re quite right,’ he said suddenly, ‘I didn’t enjoy the operation.’

Thoms grinned good-naturedly and then looked sympathetic.

The door opened and Dr Roberts came in.

‘I just looked in to report, Sir John,’ he began. ‘The patient’s condition is rather disquieting. The camphor injection helped matters at the time but the pulse is still unsatisfactory.’ He glanced nervously from one surgeon to the other and polished his glasses. ‘I must confess I feel rather anxious,’ he said. ‘It’s—it’s such an important case.’

‘All cases are important,’ said Phillips.

‘Of course, Sir John. What I meant to convey was my possible over-anxiety, occasioned by the illustriousness of the patient.’

‘You speak like your books, Roberts,’ said Thoms facetiously.

‘However,’ continued Roberts with a doubtful glance at the fat little man. ‘However, I am anxious.’

‘I’ll come and look at him,’ answered Phillips. ‘I can understand your concern. Thoms, you’d better come along with us.’

‘I won’t be a minute, sir.’

‘There’s something about his condition that one doesn’t quite expect,’ Roberts said. He went into details. Phillips listened attentively. Thoms darted a complacent glance at the mirror.

‘I’m ready,’ he told them.

He turned to Roberts.

‘That’s a rum-looking old stethoscope you sport, Roberts,’ he said jovially.

Roberts looked at it rather proudly. It was an old-fashioned straight instrument of wood with a thick stem, decorated by a row of notches cut down each quadrant.

‘I wouldn’t part with that for the latest and best thing on the market, Mr Thoms,’ said Roberts.

‘It looks like a tally-stick. What are the notches in aid of?’

Roberts looked self-conscious. He glanced deprecatingly at Phillips.

‘I’m afraid you’ll set me down as a very vain individual,’ he said shyly.

‘Come on,’ said Thoms. ‘Spill the beans! Are they all the people you’ve killed or are they your millionaire patients?’

‘Not that—no. As a matter of fact, it is a sort of tally. They represent cases of severe heart disease to whom I have given anæsthetic successfully.’

Thoms roared with laughter and Roberts blushed like a schoolboy.

‘Are you ready?’ asked Phillips coldly.

They all went out together.

In the theatre Sister Marigold, Nurse Banks, and a nurse who had appeared to ‘scally’, cleaned up and prepared for another operation, an urgent bronchoscopy, to be performed by a throat specialist. Jane had been taken off to the nurses’ quarters.

‘Two urgent ops. in one evening!’ exclaimed the matron importantly; ‘we are busy. What’s the time, Nurse?’

‘Six thirty-five,’ said Banks.

‘Whatever was the matter with Harden, Matron?’ asked the scally.

‘I’m sure I don’t know, Nurse,’ rejoined Sister Marigold.

‘I do,’ said Nurse Banks grimly.

Sister Marigold cast upon her a glance in which curiosity struggled with dignity. Dignity triumphed. Fortunately the scally was not so handicapped.

‘Well, Banks,’ she said, ‘come clean. Why did she faint?’

‘She knew the patient.’

‘What! Knew Sir Derek O’Callaghan? Harden?’

‘Oh, yes! Their people were neighbours down in Dorset, don’t you know,’ aped Banks with what she imagined to be the accent of landed proprietorship.

Sister Marigold’s starch seemed to crackle disapproval.

‘Nurse Harden comes of a very nice family,’ she said pointedly to the scally.

‘Oh, most fraytefully nayce,’ jeered Banks. ‘Yes, she knew O’Callaghan all right. I happened to say, about a month ago it was, that he was probably the most completely unscrupulous of the Tories and she didn’t half flare up. Then she told me.’

‘Thank you, Nurse Banks, that will do,’ said Matron icily. ‘The theatre is not the place for politics. I think we are ready now. I want a word with the doctor about this case.’

She rustled out of the theatre.

‘You’ve got a nerve, Banks,’ said the scally. ‘Fancy talking like that about Sir Derek. I think he looks lovely in his photos.’

‘You think because he’s got a face like Conrad Veidt he’s a suitable leader of the people—a man to make laws. Typical bourgeois ignorance and stupidity! However, he’s probably the last of his species and he’ll be the first to go when the Dawn breaks.’

‘Whatever are you talking about?’

‘I know what I’m talking about.’

‘Well, I’m sure I don’t. What Dawn?’

‘The Dawn of the Proletariat Day.’

‘What’s that? No, don’t lose your hair, Banks. I’d like to know.’

‘You will know,’ said Banks. ‘Very shortly.’

Upon which the throat specialist appeared and inquired if they were all ready for him. In ten minutes’ time the figure of a child was wheeled into the theatre and once again the fumes of the anæsthetic rose like incense about the table. In another ten minutes the child was taken away. Nurse Banks and the scally began to clear up again. The throat specialist whistled as he washed up in the anteroom. He thrust his head in at the door, remarked: ‘No rest for the wicked, Nurse,’ and took himself off.

The two women worked in silence for a little while. Nurse Banks seemed preoccupied and rather morose.

‘Hallo,’ said the scally, ‘there’s Pips growling on the stairs.’ (‘Pips’ was hospital slang for Sir John Phillips.) ‘And Thomcat. Wonder how he is now. Sir Derek, I mean.’

Nurse Banks did not answer.

‘I don’t believe you care.’

‘Oh, I’m quite interested.’

The voices grew louder but neither of the two nurses could hear what was said. They stood very still, listening intently.

Presently there seemed to be some kind of movement. A woman’s voice joined in the conversation.

‘Who’s that?’ asked the scally.

‘Sounds like Marigold,’ said Banks. ‘God, that woman infuriates me!’

‘Ssh! What’s it all about, I wonder?’

Sir John Phillips’s voice sounded clearly above the others.

‘I’d better attend to that,’ it said.

‘Pip sounds absolutely rampant’ breathed the scally.

‘Yes,’ said Thoms clearly. ‘Yes.’

A sound of footsteps. Then suddenly the door into the theatre opened and O’Callaghan’s special nurse burst into the room.

‘Isn’t it frightful!’ she said. ‘Oh, isn’t it frightful!’

‘What? What’s the matter with you?’

‘He’s dead—Sir Derek O’Callaghan’s dead!’

‘Nurse!’ The scally gazed at her speechless.

‘It really is awful,’ said Nurse Graham. ‘Lady O’Callaghan is there now—she wanted to be left alone with him. I felt I simply must tell somebody.’

There was a dead silence, and then, prompted perhaps by some kind of mental telepathy, they both turned and stared at Banks.

The older woman’s head was tipped back. She held her arms stiffly at her sides. Her eyes shone and her lips worked convulsively.

‘Banks!’ said the scally, ‘Banks! How can you behave like that? I believe you’re glad he’s gone!’

‘If I hadn’t cast off the worn-out shackles of religion,’ said Banks, ‘I should say “Praise the Lord for He hath cast down our Enemy”.’

‘You disgusting old horror,’ said the special, and went out of the theatre.

The Nursing Home Murder

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